Auxiliary delivered school based oral health promotion among 12–14-year-old children from a low resource setting–A cluster randomized trial

Objectives

This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12–14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India.

Methods

The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3 months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self-administered KAP questionnaire were evaluated at baseline and 1-year follow-up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance.

Results

The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001).

Conclusions

Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.