School oral health program implemented by school health nurses and teachers in Kottayam, Kerala.
- Conditions
- Oral Health ProblemsDental CariesGingivitis
- Registration Number
- CTRI/2018/01/011366
- Lead Sponsor
- Government Dental College
- Brief Summary
**Backgroundand Objectives**
Loworal health priority and poor access to dental care have contributed to largeunmet oral health needs in rural communities in developing nations such as India.The role of school based oral health promotion delivered by teachers and schoolhealth nurses has not been evaluated so far. This study compared the changes inoral health knowledge, attitude, practices (KAP) and oral health indicatorsamong 12-14 year old children who received a school based oral health promotionto age matched controls from a different panchayat.
**Methods**
Aschool based cluster randomized design was used. The intervention, provided byschool teachers and school health nurses appointed by National Health Mission, consistedof oral health education (once in 3 months), weekly classroom based sodiumfluoride mouth rinsing for one year and biannual oral health screening/referral by school health nurses. The control arm did not receive theseinterventions. Oral health indicators and KAP were evaluated at baseline andone-year follow-up. KAP was assessedusing a self-administered questionnaire in Malayalam. Oral health indicatorsincluded oral hygiene index simplified, net caries increments using DMFT/DMFS, preventedfraction, number of sites with gingival bleeding, changes in care index,restorative index, treatment index and dental attendance.
**Results**
The percentageimprovement in total KAP score, oral hygiene and gingival bleeding frombaseline to follow up was higher in the intervention group (*p* <0.05). Though the net cariesincrement in DMFT and DMFS was higher in the control group, the difference wasnot statistically significant. The prevented fraction for net caries incrementwere 23.33% and 20.51% for DMFT and DMFS respectively. Students in theintervention group had a higher proportion of dental attendance (OR 2.92, *p* <0.001). The changes in treatmentindex, restorative index and care index were 20.5%, 14.5% and 5.6% respectivelyin the intervention group. These were significantly higher than that observedin the control group (*p* <0.001).
**Conclusions**
Inclusionof available primary care auxiliaries like school health nurses and teachers inoral health promotion is an effective and sustainable strategy to improve oralhealth indicators and utilization in rural areas in Kerala. The adoption ofthis school oral health policy will enable us to address the problems in oralhealth and achieve progress at par with the excellent general health indicatorsof Kerala.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 700
- 1.School children aged 12-14 years at baseline from Govt/ Govt.
- aided schools in Ettumanoor & Athirampuzha, Kottayam, Kerala.
- 2.Written informed consent from Parent/ Guardian and Principal of school.
1.Children undergoing orthodontic treatment 2.Physically & mentally challenged children.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To compare the changes in Oral health determinant, knowledge, attitude and practices among beneficiaries of this program as compared to a control group 6 months | 1 year
- Secondary Outcome Measures
Name Time Method Proportion of untreated caries caries increment
Trial Locations
- Locations (1)
Government Dental College Kottayam
🇮🇳Kottayam, KERALA, India
Government Dental College Kottayam🇮🇳Kottayam, KERALA, IndiaDr Vivek NarayanPrincipal investigator9895319384drviveknarayan@gmail.com