Changes in adolescents' oral health status following oral health promotion activities in Tanzania

Abstract

Objective. To assess the impact of oral health promotion integrated with a health promoting school (HPS) initiative on the oral health outcomes of secondary school students. Materials and method. Using an urban–rural stratified cluster randomized approach, the intervention was applied to secondary school students in Arusha, Tanzania. In the urban, three control (n = 315) and two intervention (n = 214) schools performed oral clinical examination and questionnaires at baseline. In rural the corresponding figures at baseline were two (n = 188) and three (n = 360) schools. After 2 years, 374 and 358 students remained in the intervention and control arms. Results. Mean number of decayed teeth (DT) increased in the intervention (mean score 1.0 vs 1.7, p < 0.001) and control schools (mean score 1.2 vs 1.7, p < 0.001). Mean number of teeth with plaque decreased significantly in intervention and control schools. No significant difference in caries increment and plaque decline scores was observed between groups. Mean number of teeth with bleeding decreased (0.5 vs 0.3, p < 0.05) in intervention schools, whereas no change was observed in the control schools (0.4 vs 0.5, p = 0.051). Increment in mean number of DT between baseline and follow-up was largest and smallest in students who, respectively, deteriorated and improved their plaque and bleeding scores. Conclusion. The intervention activities did not show any effect with respect to dental caries, calculus and plaque status among the students investigated. Compared with the control group, more favorable changes in the intervention group occurred with respect to bleeding on probing, suggesting a weak but positive effect on students' oral hygiene status.

Key Words::

• health promoting schools
• adolescents
• oral health status

Acknowledgments

This work was part-funded by a grant from the Norwegian Cooperation Programme for Development, Research and Education (NUFU)(ID NR 2007/10051) and in part from the Faculty of Medicine and Dentistry, University of Bergen. It was facilitated by the collaborating institutions: Muhimbili University of Health and Allied Sciences and Centre for Educational Development in Health, Arusha, Tanzania, and the Universities of Oslo and Bergen, Norway. The authors acknowledge and appreciate Arusha municipality, Arusha rural and Meru administrative councils' authorities, Muhimbili University of Health and Allied Sciences (MUHAS), Ministries of Health and Social Welfare and Education in Tanzania, and REK VEST of Norway for permission to conduct the study. The authors are indebted to the study participants, parents and their school administrations for making this study a reality.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.