Effect of school oral health education through curriculum changes on behaviour and oral health status of children aged 10-15 years in Ranchi city: A Randomized Control Trial

Oral diseases are largely preventable and linked to poor oral hygiene practices that begin during childhood. Schools are important platforms for promoting healthy behaviour and preventing oral health problems. The school oral health education programme has been found to be effective in preventing oral diseases and instilling lifelong positive behavioural changes among adolescents. However, the current school curriculum in India lacks a structured approach towards oral health education and disease prevention. According to the National Oral Health Survey 2002–2003, the maximum prevalence of oral diseases is observed among children aged 10 to 15 years. The survey also revealed that over 40 percent of 12-year-old children across rural and urban areas had no knowledge of oral health problems. The draft National Oral Health Policy advocates for an intersectoral approach that includes schools, aiming for a 15 percent reduction in the burden of oral diseases by 2030. This study seeks to generate evidence on the effectiveness of integrating oral health education into the school curriculum in a structured format.

The primary aim of the study is to assess and compare the effect of school oral health education, with or without changes to the school curriculum, on the behaviour and oral health status of children aged 10 to 15 years. A parallel design cluster randomized controlled trial will be conducted over a period of two years in government schools of Ranchi city. The study population includes male and female students from grades 5 to 9. Schools will be selected using cluster random sampling, and each school will represent one cluster. A total of 10 clusters will be selected and randomized into two groups: the intervention group and the control group, with five schools in each group. The control group will receive oral health education by a team of dentists during visits at baseline, third, sixth, ninth, and twelfth months. The intervention group will receive the same oral health education plus curriculum modifications delivered by trained physical education teachers. These modifications include monthly lectures of 30 minutes, provision of IEC materials, guided brushing technique demonstrations, self-monitoring practices, and knowledge about oral diseases and their prevention. All participants will be provided with toothbrushes and toothpaste during the study period to ensure standardized oral hygiene practices.

The oral health status of the students will be evaluated using the WHO Oral Health Assessment Form for Children 2013, and their behaviour will be assessed using the WHO Oral Health Questionnaire for Children. The sample size was estimated at 410 participants per group based on expected reduction in gingivitis prevalence by 33.33 percent with an ICC of 0.8 at 95 percent confidence and 80 percent power. Data analysis will include descriptive statistics, repeated measures ANOVA, and post hoc tests using R software. Ethical approval will be obtained from the RIMS Institutional Ethics Committee. Permissions will also be secured from the education department and participating schools. Parental consent will be obtained for all children. The study aims to provide evidence for effective school-based oral health education and support policy-level decisions for integration of oral health into the national and state education systems.