[A 2-year evaluation of different methods of dental caries prophylaxis in a sample school-aged population]. Evaluation of an educational program for children with high risk of caries. A cluster randomized controlled trial of a dental health education program for 10-year-old children. School-based intervention to promote preadolescents' gingival health: a community trial.
Caries is currently considered to be the most widespread disease affecting mankind; it is calculated in fact that around 90% of the world population suffers from caries. Carious pathology therefore plays a key role, not least due to the high social costs which it entails, and, for this reason, research into appropriate methods of prevention which can to some extent limit the incidence of caries are of particular interest. MATERIALS AND METHODS. The study was performed in a group of 1475 selected primary-school children. After having subdivided the population in three groups, an initial dental examination was carried out and the results obtained were quantified by calculating DMFT. The first group (492 children) was instructed to follow the rules of oral and dietary hygiene. The second group (501 children), in addition to the instructions given to the first group, also received fluoro-prophylactic treatment. Lastly, the third group (482 children) were used as a reference sample and did not receive any form of instruction or treatment. RESULTS. After two years DMFT values were increased in all three groups; in detail, values rose 0.41 in the first group, 0.38 in the second group, and 0.81 in the third group. DISCUSSION AND CONCLUSIONS. Scrupulous oral hygiene and a correct diet represent a prophylactic measure of outstanding importance in terms of carious pathology. The minimum difference observed between the first and second groups should probably be attributed to the fact that fluoro-prophylactic treatment requires a period of more than 24 months before appreciable results can be seen. The goal of this study was to evaluate a 15-month educational program designed to children. The sample consisted of 60 six-year olds, randomly assigned into control and experimental group. The control consisted of tooth brushing training, once a year. The experimental group received intensive individual tooth brushing training every three months and guidance on oral health. Initially, both groups were assessed using plaque, gingival, dmfs and DMF-S indexes every three months. In the control, no statistically significant difference was observed for plaque and gingival indexes. The experimental group showed a statistically significant reduction in mean values for two indexes. The caries indexes showed no statistically significant difference. The proposed educational program developed was efficient in reducing gingival and plaque indexes as well caries incidence. Using a cluster randomized trial, this study tested the effectiveness of a dental health education program designed to improve the oral hygiene and dental knowledge of 10-year-old children.
                Thirty-two primary schools in the northwest of England participated. After a baseline assessment of plaque and the completion of a dental knowledge questionnaire by the children, the schools were allocated randomly to active or control groups. Children in schools allocated to the active group received the dental health program, which consisted of four one-hour lessons. After four months the children were examined clinically and scored for plaque, and a second questionnaire was administered. The schools in the control group were then allocated randomly to receive the program or not over the following three months, the program being withdrawn from the schools who initially received it. A further assessment of plaque was made and a questionnaire administered seven months after the baseline of the study.
                The active groups had 20 percent and 17 percent lower mean plaque scores than the control group at four and seven months (P < .001). The children's knowledge of which type of toothbrush should be used and the role of disclosing tablets improved in the initial test group when compared with the control group and this was retained over the second part of the study.
                The children receiving the program had significantly lower mean plaque scores and greater knowledge about toothbrushes and disclosing tablets than the control children who had not received the program. Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health.
                A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE).
                At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class-work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome.
                When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.
Currently, there is insufficient evidence for the efficacy of primary school-based behavioural interventions for reducing caries. There is limited evidence for the effectiveness of these interventions on plaque outcomes and on children's oral health knowledge acquisition. None of the included interventions were reported as being based on or derived from behavioural theory. There is a need for further high quality research to utilise theory in the design and evaluation of interventions for changing oral health related behaviours in children and their parents.