Effectiveness of a School-Based Oral Health Promotion Program on Dental Caries Among Iraqi School Children: A Cluster Randomised Controlled Trial

• Published in: International dental journal Vol. 75; no. 2; pp. 744 - 751
• Main Authors: Ghasemi, Hadi, Alautry, Hanan Fadhil, Khoshnevisan, Mohammed Hossein, Namdari, Mahshid
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.04.2025; Elsevier
• Subjects: Cariostatic Agents - therapeutic use; Child; Cluster randomised controlled trial; Dental caries; Dental Caries - epidemiology; Dental Caries - prevention & control; Dentistry; DMF Index; Female; Fluoride; Fluorides, Topical - administration & dosage; Fluorides, Topical - therapeutic use; Health Education, Dental; Health Promotion - methods; Humans; Iraq - epidemiology; Male; Oral Health; Oral health education; Promotion program; School Health Services; Schoolchildren; Scientific Research Report; Sodium Fluoride - administration & dosage; Sodium Fluoride - therapeutic use; Iraq; Dental caries; Oral health education; Schoolchildren; Fluoride; Promotion program; Cluster randomised controlled trial
• ISSN: 0020-6539; 1875-595X; 1875-595X
• DOI: 10.1016/j.identj.2024.07.1214

To assess the effectiveness of a school-based oral health promotion program on dental caries of permanent dentition among Iraqi children. A cluster randomised controlled trial was conducted with a parallel study group, comprising 8-10-year-old schoolchildren, 186 in each group. At the beginning of the study, subjects in the intervention group received oral health education and a single dose of 5% sodium fluoride varnish for all teeth surfaces while the control group only received oral health education. The primary outcome data in this study were caries increment and incidence after six months. The secondary outcome data was any change in oral health behaviors in the students of both groups after 3 months. The caries status was recorded according to International Caries Detection and Assessment System (ICDAS). Statistical analyses included the Chi-square test, McNemar test, independent t-test, simple and multiple logistic regression models. Study participants included 372 children with no significant difference in baseline characteristics between intervention and control groups. An increase was evident in the mean scores of DMFS, DMFT, number of children with DMFT > 0, and DS > 0 for both control and intervention groups at six-month follow-up but this increase was significantly higher for the control than intervention group (P < .001). Among all variables included in the multiple logistic regression model, just being in the intervention group showed a significant effect in which children in the control group had a 4.2-fold (95% CI: 2.36-7.54) greater chance for developing new caries than children in the intervention group. There was a statistically significant increase in the percentage of children with favourable levels of behaviors between baseline and 3-month follow-up (P < .05, P < .001). Providing access to oral health services such as oral examination, fluoride varnish application, and oral health education to reduce dental caries and improve oral health practices seems to be effective among primary schoolchildren.