School - based oral health promotion strategies: A global scoping review.

Abstract

This scoping review aims to assess the extent of coverage of school health programs globally, map strategies across settings, and summarize outcomes and reported domains in literature. Guided by Arksey and O'Malley framework, an extensive search was performed across PubMed, Scopus, and Web of Science till February 2026, identifying 13,522 database records and 37 additional source records. After removing 2271 duplicates, 11,288 records were screened, and 84 studies met inclusion criteria. Eligible studies were experimental or observational research evaluating school-based oral health programmes for children involving a minimum of two schools at the district level. Three reviewers independently extracted data, and findings were synthesised using descriptive statistics and thematic analysis guided by the WHO Health Promoting Schools framework. The study identified seven key strategies for strengthening school oral health promotion, including implementing public health policies, delivering oral health services, integrating oral health into broader health programs, fostering collaboration and partnerships, emphasising reinforcement and motivation, ensuring optimal resource allocation, and creating a safe school environment. These strategies varied in extent, reach, and scope, ranging from national to local, from whole-population approaches to targeted population, and from purely educational efforts to comprehensive services. Although various strategies are reported, most focus on educational and behavioural interventions, with limited documentation of system-level approaches, particularly in developed countries.