Original Article

Effect of an Oral Health Promotion Program Including Supervised Toothbrushing on 6- to 7-Year-Old Schoolchildren: A Randomized Controlled Trial

Abstract

Objectives: The purpose was to evaluate the impact of an oral health promotion program including supervised toothbrushing and educational packages for parents on parent’s knowledge and oral health status of 6- to 7-year-old schoolchildren.
Materials and Methods: A multi-stage cluster random sampling method was applied, and schools were allocated to intervention and control groups. After ethical clearance and baseline evaluation, an intervention package consisting of supervised toothbrushing at the school setting, an educational package for parents, and a home package containing toothbrush and fluoridated toothpaste (1000 parts-per-million) were delivered. A post-intervention evaluation was performed after one month on parents’ oral health knowledge and oral hygiene of children using the Oral Hygiene Index Simplified (OHI-S). Schools were considered as a unit of randomization, and a generalized estimating equation (GEE) analysis was performed to apply the cluster effect. Descriptive and analytical analyses were performed using SPSS 22 software.
Results: Overall, 701 subjects were re-examined (response rate of 95%). At the one-month follow-up, being in the intervention group (P<0.001, B=-0.028, 95% confidence interval (CI)=-0.33, -0.23) and having higher socioeconomic status [P=0.01, B=-0.12, 95% CI=-0.22, -0.03) were significantly associated with improved oral hygiene status. In the post-test evaluation, parents’ knowledge improvement score regarding oral health in the intervention group was not statistically different from that of the controls (0.51 vs. 0.23). However, the ∆OHI-S improved in the post-test evaluation (-0.27±0.02 vs. 0.02±0.02; P<0.001).
Conclusion: Children showed improved oral hygiene status, as measured by the OHI-S, after the program consisting of supervised toothbrushing.

1. Dos Santos APP, de Oliveira BH, Nadanovsky P. A systematic review of the effects of supervised toothbrushing on caries incidence in children and adolescents. Int J Paediatr Dent. 2018 Jan;28(1):3-11.
2. Cooper AM, O'Malley LA, Elison SN, Armstrong R, Burnside G, Adair P, et al. Primary school‐based behavioural interventions for preventing caries. Cochrane Database Syst Rev. 2013 May 31;(5):CD009378.
3. Petersen PE, Hunsrisakhun J, Thearmontree A, Pithpornchaiyakul S, Hintao J, Jürgensen N, et al. School-based intervention for improving the oral health of children in southern Thailand. Community Dent Health. 2015 Mar;32(1):44-50.
4. Jurgensen N, Petersen P. Promoting oral health of children through schools - Results from a WHO global survey 2012. Community Dent Health. 2013;30(4):204-18.
5. Nakre PD, Harikiran AG. Effectiveness of oral health education programs: A systematic review. J Int Soc Prev Community Dent. 2013 Jul;3(2):103-15.
6. Frazão P. Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized controlled trial. BMC Oral Health. 2011 Mar 22;11:11.
7. Yekaninejad MS, Eshraghian MR, Nourijelyani K, Mohammad K, Foroushani AR, Zayeri F, et al. Effect of a school‐based oral health‐education program on Iranian children: results from a group randomized trial. Eur J Oral Sci. 2012 Oct;120(5):429-37.
8. Babaei A, Pakdaman A, Hessari H, Shamshiri AR. Oral health of 6–7 year-old children according to the Caries Assessment Spectrum and Treatment (CAST) index. BMC Oral Health. 2019 Jan 17;19(1):20.
9. Saied‐Moallemi Z, Virtanen JI, Vehkalahti MM, Tehranchi A, Murtomaa H. School‐based intervention to promote preadolescents’ gingival health: a community trial. Community Dent Oral Epidemiol. 2009 Dec;37(6):518-26.
10. Greene JG, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc. 1964 Jan;68:7-13.
11. Stein C, Santos NML, Hilgert JB, Hugo FN. Effectiveness of oral health education on oral hygiene and dental caries in schoolchildren: Systematic review and meta‐analysis. Community Dent Oral Epidemiol. 2018 Feb;46(1):30-37.
12. Sehrawat P, Shivlingesh KK, Gupta B, Anand R, Sharma A, Chaudhry M. Oral health knowledge, awareness and associated practices of pre-school children's mothers in Greater Noida, India. Niger Postgrad Med J. 2016 Jul-Sep;23(3):152-7.
13. Kwan SY, Petersen PE, Pine CM, Borutta A. Health-promoting schools: an opportunity for oral health promotion. Bull World Health Organ. 2005 Sep;83(9):677-85.
14. Haleem A, Siddiqui MI, Khan AA. School-based strategies for oral health education of adolescents--a cluster randomized controlled trial. BMC Oral Health. 2012 Dec 18;12:54.
15. Gholami M, Pakdaman A, Montazeri A, Virtanen JI. Evaluation of the impact of a mass media campaign on periodontal knowledge among Iranian adults: a three-month follow-up. PLoS One. 2017 Jan 6;12(1):e0169668.
16. Oberoi SS, Sharma G, Oberoi A. A cross-sectional survey to assess the effect of socioeconomic status on the oral hygiene habits. J Indian Soc Periodontol. 2016 Sep-Oct;20(5):531-542.
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IssueVol 17 (Continuously Published Article-Based) QRcode
SectionOriginal Article
DOI https://doi.org/10.18502/fid.v17i19.4313
Keywords
Child Schools Health Education Dental Toothbrushing
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How to Cite
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Babaei A, Pakdaman A, Hessari H. Effect of an Oral Health Promotion Program Including Supervised Toothbrushing on 6- to 7-Year-Old Schoolchildren: A Randomized Controlled Trial. Front Dent. 2020;17.

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