Short and long term evaluation of changes in oral cleanliness, following repeated dental health education in high risk schools in Rochdale, England

Abstract

Schools showing a high percentage of pupils needing referral for dental treatment following the last full dental inspection were targeted for intensive dental health education. The aims of the study were to improve the ability of children, from schools where the dental status is known to be poor, to clean their teeth effectively, and to evaluate any improvements in cleanliness following the implementation of repeated dental health education teaching module(s), and finally to discover whether actual cleanliness reflected reported brushing activity. All children were tested at baseline. The schools were divided into three groups: a control group and two test groups. One test group received intensive dental health education twice in a school year; the second test group received dental health education every term over a school year. These groups were again tested with the control. The control then received dental health education (once) and, one year on, all three groups were retested. At short term evaluation, both test groups scored higher on cleanliness than the original control, but those who received dental health education every term were very much cleaner.

At the long term follow-up, there was no significant difference between the groups, however all three groups had retained improved cleanliness over baseline levels. Cleanliness of teeth matched well with reported toothbrushing activity in the morning. The study, initially, had been intended as a randomised control trial. However, the head teachers of schools randomly assigned as ‘controls’ refused, on the grounds that they considered it unethical to withhold dental health education from children who have high levels of dental disease. This study highlights the problems of following the ‘Medical Model’ of scientific study when applied to ‘population’ studies in the real world.

Key words:

• oral hygiene
• dental health education
• children