Designing school programmes to be effective vehicles for changing oral hygiene behaviour

Abstract

Schools are a commonly used setting for dental health education, health promotion and interventions with preventive agents. However, traditional dental health education programmes are rarely designed to be effective change agents. Twice daily tooth brushing with fluoride toothpaste has consistently been shown to be an important behaviour for controlling dental caries in children. Ideally, parents incorporate twice daily brushing into their child’s hygiene routine. Families where brushing is irregular are over-represented in areas of socio-economic deprivation and the effects of irregular oral hygiene are often compounded by cariogenic diets. Therefore, in communities with high caries levels, a targeted community approach to prevention can provide additional benefit, through fluoride programmes delivered in school. It is essential that dental health education programmes are designed to recognise the social, cultural and environmental context in which the behaviours occur. This paper provides a new framework to classify school programmes. In addition, evidence-based guidance is developed of the necessary components for programmes to enhance effectiveness in establishing the key behaviour of twice-daily tooth brushing with fluoridated toothpaste.