Assessing the effectiveness of a school-based oral health promotion programme in Yichang City, China

Abstract

Objectives: To assess the outcome of oral health promotion in schoolchildren over a 3-year period in Yichang City, Hubei, China.

Methods: In a cluster randomized controlled trial, the concept of the World Health Organization Health Promoting Schools Project was applied to primary schoolchildren. Seven intervention schools and eight control schools were randomly selected from one district by stratified cluster sampling. The study was conducted as a 3-year follow-up study. After 3 years, 661 children remained in the intervention group and 697 children in the control group. Data on dental caries, plaque accumulation, and sulcus bleeding were collected by clinical examination, while behavioural data were gathered by self-administered questionnaires.

Results: The 3-year net mean DMFS increment score was 0.22 in the intervention schools and 0.35 in the control schools (P < 0.013). A statistically significant difference in mean plaque (P < 0.013) and sulcus bleeding (P < 0.005) increment scores after 3 years was found between the two groups. Statistically significant higher scores were observed in restorations received and sealants placed, and a lower score in untreated dental caries, in children from the intervention group than the control group after 3 years (P < 0.01). In addition, more children in the intervention schools adopted regular oral health behavioural practices such as brushing their teeth at least twice a day, visiting the dentist within the past calendar year, and using fluoride toothpaste.

Conclusion: The study suggests that the school-based oral health promotion was an effective way to reduce new caries incidence, improve oral hygiene and establish positive oral health behavioural practices in the targeted schoolchildren.