Oral health promotion in schools: rationale and evaluation.

Abstract

Purpose – The purpose of this paper is to explain the rationale and potential for the WHO health promoting schools (HPS) to improve children’s oral health, and describe validated quantitative methodologies and qualitative approaches to measure program impact. Design/methodology/approach – Critical discussion of the impact of poor oral health and potential for school-based educational intervention, and evaluation methodologies used by the authors. Findings – Using HPS to improve oral health is relevant because dental caries and gingivitis/ periodontitis negatively impact children’s health and quality of life worldwide. WHO has called for effective community-based oral health promotion programs; intervention is simple and low cost; robust evaluation measures exist – the decayed missing filled teeth index and change in cavity rate allow quantitative comparison of oral health status; and questionnaires document changes in knowledge, practices, diet, health-related quality of life, and pain. Practical implications – Poor oral health is a major health issue. Established measures to improve oral hygiene offer an achievable, low-cost HPS entry point; the “knowledge” and “healthy practices” components central to the WHO HPS model are tried and tested and multiple potential benefits are documented. Poor oral health is a non-stigmatized issue, hence intervention is readily accepted, and effective evaluation tools provide evidence of program effect over a short (two to three years) timeframe. Originality/value – Oral health promotion is more affordable and sustainable than the cost of traditional restorative treatments especially in middle- and low-income countries. Success with oral health leads to confidence for expansion of HPS activities to address other health issues relevant to the school community.