Oral Health Program Research Articles

Fit for Purpose? The Suitability of Oral Health Outcome Measures to Inform Policy.

Oral health research and program evaluation should consider alternative outcome measures for population oral health other than the DMFT index.

Home-based oral health program for adults with intellectual disabilities: An intervention study

BackgroundPoor oral health is common in adults with intellectual disabilities leading to risk of mouth and lung infections. Yet, little is known about the benefits of preventative oral health programs. Objective/hypothesisThis prospective longitudinal experimental mixed methods study evaluated the efficacy of an oral health program aimed at improving knowledge and behaviours in adults with intellectual disabilities living in supported housing. MethodsA 90-min training session was provided to residents and their staff at 12 houses (56 residents; 67 staff). Follow-up training sessions (at 1 week, 1,2,3 months) were tailored to the learning abilities, behavioural/physical challenges, and independence of residents. Outcome measures were collected pre, 1, 2 and 3 months (n = 36): dental exam, plaque index, gingival signs, tongue coating index and behavioural rating scale. At 3 months, support workers (n = 10) and residents (n = 19) were interviewed. Residents’ interviews were supported by Talking Mats®. ResultsMost residents (94%) required support for oral cares; with 63% fully dependant on their support workers. 24 (63%) residents had significantly improved plaque scores at 3 months (p < .001). Resident interviews were restricted by communication competency but supported interviews indicated positive responses to 3-sided toothbrush 91%, interdental brush/flosser 60%, and mouthwash 100%. Support worker interviews revealed perceived health and social benefits including fresher breath and benefits of routines. ConclusionsOral health programs for adults with intellectual disabilities living in supported housing are well received by staff and residents, leading to changes in oral care routines and measurable changes in oral health.

The Knowledge, Attitude, and Practice of Lebanese Mothers Toward Their Children's Oral Health: A Cross-Sectional Survey.

This study aims to assess the knowledge, attitude, and practice of Lebanese mothers toward their children's oral health, examine the association between the three variables, and identify their predictors. A cross-sectional online survey was administered to Lebanese mothers residing in Lebanon with children aged six months to 12 years between April and May 2022. The survey was administered to mothers from various geographical areas who presented to academic medical centers, private clinics, and dispensaries. The survey gathered sociodemographic data as well as assessed the knowledge, attitude, and practice of the participating mothers toward their children's oral health. A total of 357 responses were included in the final analysis.The mean age of mothers was 32.67 years +/- 6.35. The majority of mothers had one or two children (35.8% and 37.5%, respectively). More than two-thirds of the mothers were unemployed. Only 13% of the mothers followed best practices for their children's dental health, while 48.6.2% possessed above-average knowledge and 88.9% had great attitudes. Mothers with a university education had higher knowledge, better attitudes, and practice scores than those with school-level education (elementary, high school). Employed mothers had a significantly better knowledge score (p=0.036) and practice score (p=0.043) than unemployed mothers. The decrease in the number of children was associated with an increase in the maternal knowledge score. An increase in the mother's age was associated with a higher knowledge score. The findings of this study suggest the need for targeted oral health education programs for Lebanese mothers to enhance their attitudes and practices toward their children's oral health. It highlights the importance of early oral health interventions and emphasizes the significant role of mothers in promoting good oral health practices for their children. Further research is needed on a larger scale to comprehensively understand these variables and inform the development of appropriate national oral health programs for children in Lebanon.

A case study of the long-term sustainability of an oral health program for persons experiencing homelessness.

Stakeholders engaged in funding health programs and investing in human capital are concerned that their investments lead to beneficial long-term outcomes and do not fade from existence when funding streams dry up. However, dissemination and implementation researchers often pay little attention to what happens after programs are implemented. An essential function of the public health nurse operating at the executive management or leadership level is to evaluate overall effectiveness, quality, and sustainability of programs and to design systems-level quality initiatives and evaluation plans that foster program sustainability. This article applies a conceptual framework for sustainability to an oral health program serving persons experiencing homelessness, exploring the essential programmatic, community, and organizational factors that have positively impacted the long-term sustainability of the program. Lessons learned from a model program that has thrived in a political and economic resource poor climate may assist the public health nurse in planning and developing health programs that can withstand the test of time even in the most challenging of circumstances.

Epidemiological Study of Oral Health among Children and Adolescent Schoolchildren in Melilla (Spain).

Dental epidemiological studies are essential for analysing and evaluating the population's health state and dental treatments provided, as well as for planning future oral health programme activities and interventions based on their findings. In order to determine the health condition of children and adolescents in connection to the prevalence of caries, caries indices (decayed and filled teeth (dft) for primary teeth and decayed, missing and filled teeth (DMFT) in permanent teeth) and periodontal indices (community periodontal index (CPI)), oral exams of children and adolescents aged 6, 12 and 15 from selected schools were conducted. To assess the achievement of the oral health objectives set for Spain in 2020, these data were compared with those acquired at the national level. At 6 years of age, 278 children were examined, the prevalence of caries was 55.6%, the dft index was 2.77 (±3.44), the DMFT was 0.19 (±0.16), the restorative index (RI) was 4.62%, and the significant caries (SiC) index was 8.40 (±2.07). At 12 years of age, 208 students were examined, the prevalence of caries found was 65.86%, the DMFT index was 1.85 (±2.22), the RI was 36.63%, the SiC index was 5.43 (±2.07), and children without the presence of periodontal pathology was 59.13%. At 15 years of age, 165 students were examined, the prevalence of caries was 70.06%, the DMFT was 3.08 (±3.39), the RI was 42.42%, the SiC index was 8.10 (±2.55), and adolescents without periodontal disease was 47.90%. Conclusions: Melilla-born children and adolescents had higher caries indicators and indices than the corresponding national averages for Spain. Teenagers under the age of 15 have a particularly high frequency of dental caries. The investigation of the children's origin is where there is the most disparity. Children of Berber descent have much higher values than children of European heritage.

A North East oral health programme in residential care homes to implement Care Quality Commission and NICE NG48 guidelines

A North East oral health programme in residential care homes to implement Care Quality Commission and NICE NG48 guidelines

Cross-Sectional Study on Oral Health-Related Quality of Life Using OHIP-14 in Migrants Children in Melilla (Spain).

Quality of life is a parameter that not only evaluates clinical parameters, but also refers to the perception of the individual in his or her sociocultural context. It also refers to psychosocial aspects that have a very important impact on people's lives. Oral health-related quality of life (OHRQoL) must also be considered when assessing oral health in any population for which an oral health program is to be developed. On this premise, and taking into account the precarious situation of refugee children housed in the Temporary Center for Migrants (CETI) in Melilla (Spain), a study was conducted to assess the oral health and OHRQoL of the children housed in the aforementioned facility. For this purpose, the 120 children in care at the time of the study underwent a basic epidemiological examination according to the recommendations of the World Health Organization (WHO), and their OHRQoL was assessed using the specific OHIP-14 questionnaire. The results show a state of oral health with a high caries prevalence (95%), high DMFT, and dft indices for the studied population. The oral health-related quality of life perceived by these children shows that pain and psychological discomfort are the areas rated worst by them. Thus, it is concluded that it is important to implement specific oral health programs for this population, based on caries prevention and pain management, which must also take into account the psychological and sociocultural aspects that have accompanied their lives.

Effectiveness of a Therapeutic Educational Oral Health Program for Persons with Schizophrenia: A Cluster Randomized Controlled Trial and Qualitative Approach.

The oral health of people with schizophrenia (PWS) is very poor, suggesting a need for oral health promotion programmes with a high level of evidence. The aim of the EBENE study (Clinicaltrials.gov: NCT02512367) was to develop and evaluate the effectiveness of a multidisciplinary therapeutic educational programme in oral health (TEPOH) for PWS. A multicentre cluster randomised controlled trial, with outpatient psychiatry centres as the unit of randomisation, was designed to compare the effectiveness of TEPOH (intervention group) versus standard care (control group). The trial was conducted in 26 outpatient psychiatry centres in France (14 in the intervention group, 12 in the control group). Eligible patients with a diagnosis of schizophrenia were enroled between 2016 and 2020 and followed for 6 months. The TEPOH group received a multicomponent intervention (comprising an introductory session, three educational sessions, and a debriefing session). The primary endpoint was the evaluation of periodontal disease as a community periodontal index (CPI) score ≥ 3 at Month 6. The trial was completed using a qualitative approach based on semi-structured interviews with caregivers conducted between July 2018 and December 2019. The trial was stopped early due to difficulties in recruiting patients. Overall, 81 patients (of 250 planned) were included, and 54 patients completed the trial: 40 in the TEPOH group and 14 in the control group. At baseline, the percentage of CPI ≥ 3 was 42.5% in the TEPOH group and 9.1% in the control group. At Month 6, the percentage of CPI ≥ 3 was 20% in the TEPOH group and 14.3% in the control group. The qualitative evaluation underlined that the professionals emphasised the "seriousness" and "assiduity" of the patients' participation in this programme and that the TEPOH reinforced carers' investment in oral hygiene. It also highlighted structural factors (lack of resources for professionals, lack of teeth in PWS, COVID-19 pandemic) that may have exacerbated the difficulties with enrolment and follow-up. The effectiveness of this TEPOH, developed for PWS as part of the EBENE study, has not been demonstrated. Certain aspects of the programme's content and implementation need to be reconsidered. In particular, an adapted subjective measurement scale should be developed.

Effect of Fluoride on Oral Health Status Among General Population Residing in High- and Low-Level Fluoride Blocks in Erode District, Tamil Nadu, India: A Cross-Sectional Study.

The aim of this study was to evaluate the fluoride levels in groundwater and their effect on oral health status among the general population of Erode district, Tamil Nadu, India. A descriptive cross-sectional study was conducted among the general population of index age groups 5, 12, 15, 35-44, and 65-74 years. A total of 540 subjects participated in the study. High fluoride blocks of Erode district were selected based on the Central Ground Water Board (CGWB), Ministry of Jal Shakti, Department of Water Resources, River Development and Ganga Rejuvenation, Government of India, 2010, and the low fluoride were taken from the Groundwater Year Book (GWYB) of Tamil Nadu and UT of Puducherry, 2018. The Oral Health Assessment Form 2013 (adult and children) of the World Health Organization (WHO) was used to assess dental caries and enamel fluorosis. Clinical examination was performed using a mouth mirror and explorer under natural illumination by a single examiner. Data obtained were processed and analyzed using IBM SPSS Statistics version 26. A Chi-squared test was employed to analyze the difference between the high and low fluoride blocks. A P value of 0.05 was set to be statistically significant. The current study had a contrary finding with the CGWB on water quality analysis of fluoride levels in drinking water for high fluoride block, Ammapet (1.12 ppm) and Anthiyur (1.08 ppm). The prevalence of enamel fluorosis in high fluoride block Ammapet was 44.4% and Anthiyur was 54.8%. The prevalence of dental caries in high fluoride block Ammapet was 45.9% and in Anthiyur was 43%. The prevalence of enamel fluorosis in low fluoride block Bhavanisagar was 27.4% and in Gobichettipalayam was 28.2%. The prevalence of dental caries in low fluoride block Bhavanisagar was 61.5%, and in Gobichettipalayam was 54.8%. This study's contradictory finding emphasizes the importance of drinking water; sanitation staff should monitor and report water fluoridation data on a monthly basis in accordance with the Water Fluoridation Reporting System, and CGWB should plan and organize a team for the upgradation of water quality in India. The National Program for Prevention and Control of Dental Diseases should look on to the endemic areas for the prevention of dental fluorosis, which should be assessed, implemented, and monitored by the public health dentist who should be recruited as oral health program officers in both central and state governments.

Baseline assessment of oral health needs among underserved populations in the United States

Introduction: There are numerous inequities in access to oral healthcare in the United States (US). Lower utilization of oral healthcare services, a higher burden of dental diseases, and poorer dental outcomes are more prevalent among US immigrants compared to US-born populations. Study Sample: A sizable population of people in Iowa are immigrants. These immigrants are from democratic republic of congo (DRC), Eritrea, Burma, Bhutan, Burundi, Ethiopia, and Afghanistan. Iowa Refugee Assessment Report of 2018 shows that dental ailment is the second most prevalent condition among new entrant refugees. As a result, the Oral Health Programs targeted an oral health intervention at US immigrant populations. Objectives: This report aims to highlight significant findings from the baseline survey to further understand the needs for oral healthcare amongst immigrant and underserved populations in Iowa. This intervention utilized community peer educators to sensitize and mobilize immigrants to better access dental services. Training modules were developed for the volunteer peer educators and educational materials were translated into the native languages of the most populous refugees (French, Swahili, and Arabic). The Oral Health Program implemented a community health campaign, developing a questionnaire to capture demographic information, knowledge, awareness, barriers to uptake of dental check-ups/oral assessment,s and preferred sources of information. Preliminary findings indicated the need for increased awareness about oral health. Findings: There is a need to leverage existing social safety net programs to deliver oral health information and foster connections between dental service providers and their target populations. This study has shown the need for continued efforts towards increasing oral healthcare among underserved ethnic/minority and immigrant populations in Iowa. Future interventions need to focus on improving access and removing structural and social barriers to dental/oral care.

Assessing the Effects of Oral Health Knowledge and Behaviours of Mothers on Oral Health of Preschool 4-6 Years Old Children

Background- Pre-school child health has always been one of the most important milestones for lifelong health research. Also, the knowledge and behaviour of the parents, especially mothers, affects children's health. The variable household-related factors and mothers, in particular, are considered to be the main role models that can improve pre-school children behaviour. Objective To determine the knowledge and behaviours of the mothers and their impact on pre-school 4-6 years old children oral health status. Method A 27 subjects’ questionnaire was prepared using previous questionnaires assessing mothers’ knowledge and behaviours towards oral health. Children's oral and dental health was examined by the researcher and scores were calculated using dmft (decayed, missing, filled, tooth) index. Accordingly, the effect of knowledge and behaviour of the mothers on their children dmft score was analysed. Chi-Square and logistic regression tests were used in the statistical analysis. Results The study population consisted of 261 pre-school children and their mothers. Which included 126 males (48.3%) males and 135 females (51.7%). The mean mothers’ oral health knowledge score was found to be 4.24  1.94. The children oral health examination through dmft scoring showed that 71.3% of children had experienced dental caries. the mean value for dmft score was 2.32  2.39. Our study showed that the mother's cumulative oral health knowledge score has a statistically significant relationship to the children oral health status. The higher the mother's oral health knowledge scores the lower their children dmft scores (p=0.001). Conclusion Mothers oral health knowledge and dental health indices in our study are lagging behind the developed countries and the WHO goal for the 21st century showing an urgent need to improve the effectiveness of preventive care in oral health programmes.

Oral health Literacy status among practicing Gynaecologists related to Expectant mothers and newborns – An Interventional study

Aims and Objectives – An Interventional study was designed to assess knowledge, attitude, and practices of gynaecologists practicing in Faridabad regarding Oral health care in expectant mothers and newborns. Materials and Methods - They were assessed using a 32 item validated self-administered questionnaire including demographic information and questions about knowledge, attitude and practice. Results - Data analysis was conducted using SPSS software (version 21) and Chi-square, 103 gynaecologists participated in the study and showed significant results with P value less than .05. Oral health manual was distributed among the gynaecologists, questionnaire was refilled and reassessment was done. It showed highly statistically significant results with p value = .0065. has shown improvement of their KAP score from 65.1750 to 81.6643. Conclusion - Thus it can be concluded that a comprehensive oral health program with the hand in hand of gynaecologists and dental specialist, is possible and has the potential to establish attitudes about the importance of maintaining optimum oral health of expectant mothers.&#x0D; Keywords – Expectant mothers, multiprofessional approach, newborn, oral Health manual.&#x0D; Source of support – Nil&#x0D; Conflict of interest – None&#x0D; Ethical clearance - Approved

Dentists' Perspective on the Impact of COVID-19 on the Utilization of Emergency Dental Services in Kuwait: A Cross-Sectional Study.

This cross-sectional study intends to evaluate dentists' perceptions of COVID-19's effects on the use of emergency dental care both during and after Kuwait's lockdown periods. A convenience sample of dentists employed by the Ministry of Health's various emergency dental clinics and School Oral Health Programs (SOHP) throughout Kuwait's six governorates were invited to take part in this study. To determine the impact of various demographic and occupational characteristics on the mean perception score of the dentist, a multi-variable model was developed. The study was conducted between June-September 2021, and a total of 268 dentists (61% males and 39% females) participated in this study. When compared to pre-lockdown periods, the overall number of patients seen by dentists had significantly decreased after the lockdown period. After lockdown, there were significantly more cases of acute pulpitis with apical periodontitis, abscesses, and pericoronitis than there were before lockdown (p < 0.05). After the lockdown, a significantly higher percentage of dentists (p < 0.05) reported using fewer droplets-generating procedures to manage patients with dental emergencies. After correcting for the other variables in the model, female dentists (β = 0.146; 95% CI = 0.071 to 1.451) and non-Kuwaiti dentist (β = 0.012; 95% CI = 0.234 to 1.854) had a significantly (p < 0.05) more positive perception of the utilization of dental services than others after adjusting for the other variables in the model. The majority of dentists perceive that the COVID-19 pandemic has had a negative impact on Kuwait's use of emergency dental services.

Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic.

To assess oral hygiene and dietary patterns in school children participating in a school-based preventive oral health program during the COVID-19 pandemic. In this cross-sectional study, an anonymous questionnaire exploring oral hygiene and dietary patterns during the COVID-19 pandemic was completed by parents of school children. Data were compared among different schools, school years, and between genders using nonparametric tests. Associations among further nominal and categorical variables related to oral hygiene and dietary habits were also assessed using the chi-square test. Only 26% (n = 32) of parents reported that their children brushed their teeth the recommended amount of twice or more per day during the pandemic. In addition, 17.2% of the parents reported less brushing than before the pandemic. A total of 40 parents (32.8%) reported that their child consumed unhealthy beverages once a day or more. Comparison between genders revealed that male participants were drinking significantly unhealthier than female (p = 0.038). Sugary foods were consumed once a day or more by 63.1% of children. No significant differences were found between public and church schools. Significant direct associations were found between changes in dietary habits and brushing frequency (p = 0.017), between parental concern regarding the interruption of the school program and decreased brushing frequency (p = 0.005), and negative changes in dietary habits (p = 0.013). Within the limitations of this study, the present significant findings observed during the pandemic support the importance of school programs in promoting oral hygiene and healthy dietary habits of children. Agius A-M, Gatt G, Cortes ARG, et al. Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic. Int J Clin Pediatr Dent 2023;16(2):205-210.

Oral health literacy and its associated factors among nurses: A cross-sectional study.

To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. A cross-sectional design following the STROBE guideline. A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health-related quality of life. OHL was measured using the validated Chinese version of the short-form Health Literacy of Dentistry (HeLD-14) scale. Descriptive statistics, the Mann-Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. The median HeLD-14 score (p25-p75) was 50.0 (44.0-54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self-reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. No Patient or Public Contribution.

Evaluation of oral health education programs for oral health of individuals with visual impairment: An umbrella review.

To exemplify, summarize and critically appraise the systematic reviews (SRs) that evaluated different oral health education (OHE) interventions in individuals with visual impairment (VI). Six electronic databases were searched for SRs evaluating OHE programs in individuals with VI. The internal validity of the included SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2) tool. The degree of overlap of the primary studies in the included SRs was calculated using the "corrected covered area (CCA)" approach. Seven SRs were included in this umbrella review that included 30 primary studies with a CCA of 26% (very high overlap). Six of the included SRs were assessed to have critically low confidence in the results, whereas only one had moderate confidence. A combination of various OHE methods for individuals with VI might be better than using one method alone to improve oral hygiene. There is no conclusive evidence that one OHE method is superior to others. However, the evidence of OHE in improving the outcomes related to dental trauma or caries is inconclusive. Furthermore, it appears that most of the evaluations of oral health programs come from limited parts of the world, and data from many other regions is lacking.

Oral Health Status of Children Age 6-12 Years in Rawalpindi, Islamabad Pakistan

Dental caries seems to be a significant public health issue and a common non-communicable disease. And is more prevalent in age group 6-12 years. There has never been a national oral health survey conducted in Pakistan between age 6-12 years in recent years. The purpose of this study was to look into the dental health of children between the ages of 6 and 12. Objectives: To determine the oral health status of children age 6-12 years using Decayed, Missed, Filled tooth Index. Methods: A cross-sectional study was carried out which included 385 children age between 6-12 years, using a simple random sampling. Children were evaluated in schools, and data collected included details on caries and the condition of the gingiva. The WHO's methodology and standards were used for oral examination. Results: Mean DMFT index of children age 6-12 years came out to be 2.28 ± 0.97. More than 2/3rd of children age between 6-12 years needs urgent dental care. Conclusion: The oral health status of children age between 6-12 years is unsatisfactory and higher DMFT index than expected. To effectively prevent and control burden of dental caries and promote gingival health, the oral health program must be implemented. Dental caries seems to be a significant public health issue and a common non-communicable disease. And is more prevalent in age group 6-12 years. There has never been a national oral health survey conducted in Pakistan between age 6-12 years in recent years. The purpose of this study was to look into the dental health of children between the ages of 6 and 12. Objectives: To determine the oral health status of children age 6-12 years using Decayed, Missed, Filled tooth Index. Methods: A cross-sectional study was carried out which included 385 children age between 6-12 years, using a simple random sampling. Children were evaluated in schools, and data collected included details on caries and the condition of the gingiva. The WHO's methodology and standards were used for oral examination. Results: Mean DMFT index of children age 6-12 years came out to be 2.28 ± 0.97. More than 2/3rd of children age between 6-12 years needs urgent dental care. Conclusion: The oral health status of children age between 6-12 years is unsatisfactory and higher DMFT index than expected. To effectively prevent and control burden of dental caries and promote gingival health, the oral health program must be implemented.

Health-Promoting Schools Project for Palestine Children's Oral Health

ObjectivesThe aim of this work was to assess the oral health outcome of a 2-year comprehensive school oral health programme based on school-health education combined with supervised toothbrushing using 1450-ppm fluoride toothpaste amongst schoolchildren in Palestine. MethodsA quasi-experimental study (2016–2018) recruited 3939 schoolchildren aged 5 to 6 years from 30 intervention schools (n = 2333) and 31 comparison schools (n = 1606). At baseline and postintervention, mothers and schoolteachers completed World Health Organization (WHO) self-administered questionnaires about oral health of children, oral health behaviour, and family factors. Of the initial participants 75.8 per cent took part in the follow up studies. In addition, 25 calibrated dentists examined dental caries of children according to WHO criteria. Trained teachers provided comprehensive oral health education to children in the classrooms and held regular oral health sessions for mothers. Children brushed their teeth with fluoride-containing toothpaste (1450 ppm fluoride). Student t-test and logistic regression were used in the statistical analysis of changes in dental health and related knowledge, behaviours, and attitudes (P < .05). ResultsIn both dentitions, dental caries experience declined over the project. The reduction in Decayed, Missing and Filled permanent Teeth and Decayed, Missing and Filled Surfaces in permanent teeth was 23.3% and 23.2% (P < .001), respectively. The drop in caries experience indices in the Gaza Strip was 8 to 4 times higher than in West Bank, and it reached 47.4% reduction. Mothers and teachers showed improvement in positive knowledge and attitudes towards dental care. Involvement of schoolteachers in oral health in schools and acceptance of dental health education materials significantly enhanced oral health behaviour of children. ConclusionsThe project recommends national implementation of an intervention for the improvement of oral health of schoolchildren and their parents in conflict zones. The project shows the importance of the WHO Health Promoting Schools concept and involving classroom-based health education carried out by schoolteachers. It is suggested to explore the health care system's capacity in hosting effective oral health programme and maintain its efficacy.

Improving oral health of adolescent girls in Kenya through education - An observational study.

Dental caries and periodontal diseases are significant health concerns in developing nations. This study assessed the impact of a comprehensive oral health education program on adolescent girls in rural Kenya. Eighty-seven girls aged 13-18 years attending school in rural Nanyuki, Kenya, were enrolled in the study. The comprehensive program included personalized oral hygiene training, education and health advocacy coaching. Dental caries, gingival inflammation and dental plaque biofilm were assessed at baseline, 1- and 2.5-year post-implementation. The intervention was highly effective in arresting pre-existing carious lesions and preventing the formation of new ones in this population. The data revealed that there was a significant remineralization of incipient caries lesion, as shown by decreases in modified ICCMS™ scores from baseline to 1-year post-implementation. From baseline to the 2.5-year post-implementation assessment, only six new carious lesions developed. Dental plaque biofilm was reduced by 83.6%, and gingival inflammation was reduced by 81.6%. A comprehensive oral health program, which included behavioural awareness and educational approaches, resulted in significant positive oral health outcomes in caries, dental plaque biofilm and gingival inflammation.

KNOWLEDGE AND INDEPENDENCE IN THE CARE OF COMMUNITY DENTAL AND ORAL HEALTH TO TEACHERS AND PARENTS OF ELEMENTARY SCHOOL STUDENTS

Dental and oral health in Indonesia is still a health problem that needs attention. Based on the Riskesdas 2018, it was reported that the prevalence of dental and oral problems in Indonesia is still very high. As many as 57.6 percent of Indonesians have dental and mouth problems. The most concerning thing is that as many as 93% of school-age children experience dental and mouth problems. This activity is intended as a comprehensive school program in Indonesia, which consists of a 21-day dental and oral health program for children at school. Implementation of the School Health Program uses an online system through the zoom application. The target participants are 5 parents and 5 teachers at SD Hangtuah 6 Surabaya. The location and time of implementation is Saturday, November 5 2022, 08.30 – 11.00 WIB by using a zoom meeting. The results of the statistical analysis used a paired sample t-test with a significance value of 0.000, this means that there is a significant difference in the level of knowledge of maintaining dental and oral health among teachers and parents of students at SD Hangtuah 6 before being given DHE material and after being given DHE through "Training of Trainers”. Teachers and parents can become pioneers in disseminating knowledge and how to maintain oral health for school-level children, as well as changing behavior in maintaining dental and oral health for the better.