Abstract
BackgroundA community-led oral health service for Aboriginal people in Central Northern NSW identified the need for oral health promotion, as well as dental treatment; in three remote communities with limited access to dental services. A three-stage plan based on the Precede-Proceed model was used to develop a school-based preventive oral health program. The program will be piloted in three schools over 12 months aimed at improving the oral health of local Aboriginal children.MethodsThe proposed program includes four components: daily in-school toothbrushing; distribution of free fluoride toothpaste and toothbrushes; in-school and community dental health education and the installation of refrigerated and chilled water fountains to supply a school water bottle program. Primary school children will be issued toothbrushing kits to be kept at school to facilitate daily brushing using a fluoride toothpaste under the supervision of trained teachers and/or Oral Health Aides. School children, parents and guardians will be issued free fluoride toothpaste and toothbrushes for home use at three-monthly intervals. Four dental health education sessions will be delivered to children at each school and parents/guardians at local community health centres over the 12 month pilot. Dental education will be delivered by an Oral Health Therapist and local Aboriginal Dental Assistant. The program will also facilitate the installation of refrigerated and filtered water fountain to ensure cold and filtered water is available at schools. A structured school water bottle program will encourage the consumption of water. A process evaluation will be undertaken to assess the efficiency, feasibility and effectiveness of the pilot program.DiscussionThe proposed program includes four core evidence-based components which can be implemented in rural and remote schools with a high Aboriginal population. Based on the Precede-Proceed model, this program seeks to empower the local Aboriginal community to achieve improved oral health outcomes.Trial registrationTRN: ISRCTN16110292 Date of Registration: 20 June 2018.
Highlights
A community-led oral health service for Aboriginal people in Central Northern New South Wales (NSW) identified the need for oral health promotion, as well as dental treatment; in three remote communities with limited access to dental services
Guided by the Precede-Proceed model, Stage 1 included an epidemiological assessment of all Aboriginal children aged 5–12 years enrolled in local schools as well as an educational and ecological assessment of the community to determine predisposing risk factors and reinforcing and enabling factors to inform a targeted oral health program
Based on the risk factors identified, the following oral health promotion strategies for Aboriginal children living in Central Northern NSW were developed, namely: increasing fluoride use through daily toothbrushing; ensuring safe and refreshing tap water is accessible to encourage the consumption of water rather sugar sweetened beverages; providing culturally competent oral health and nutrition education; and providing training programs to build capacity of the local Aboriginal community and existing health workforce to ensure oral health promotion is led and supported by the community
Summary
In-school toothbrushing with a fluoride toothpaste Daily in-school toothbrushing will be implemented in all Kindergarten to Year 6 (primary) classes in the three schools. 1000 ppm fluoride toothpaste and hard plastic storage case for the toothbrush and paste Children will brush their teeth at school once per school day under the supervision of a trained teacher and/or Oral Health Aide. The Oral Health Aide must be a local Aboriginal person to promote a culturally safe environment for children to brush their teeth at school, this may include providing individual children with support to brush their teeth They will be employed by the school for 1 h per day and will assist the classroom teachers to implement the program by supervising toothbrushing. Questionnaire responses will be analysed using descriptive statistics (SPSS software, version 22 [SPSS Inc., Chicago Ill, USA])
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