School-based oral health education increases caries inequalities
Abstract
OBJECTIVE: To evaluate the effect of one and half years of an oral health promotion program in primary schools. DESIGN: A cluster-randomized controlled trial. PARTICIPANTS: 740 students aged 9-12 years (48% female) recruited from the fifth grade of 18 different primary schools in West Pomerania, Germany. METHODS: General and oral health education was provided to the teachers in the intervention schools, which they conveyed to their students. No additional measures were conducted in the control schools. Medical and dental school examinations, as well as questionnaires for the students and their parents were conducted at baseline and follow-up. Data were analysed using Poisson regression models. RESULTS: A significant incident rate ratio between caries increment was found, with a 35% higher risk in the control group. However, parents' socioeconomic characteristics modified the effect of the program on their children, as high socio-economic status in the intervention group was associated with 94% reduction in the incidence risk ratio (p ⟨ 0.001). CONCLUSIONS: The program was effective in improving dental health among students with higher socio-economic status. No preventive effect could be found in low socio-economic status groups.
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Clinical preventive measures and traditional health education aiming at behaviour change may increase, rather than decrease, socioeconomic inequalities in oral health.
“The evidence, however, shows that such approaches are effective only in the short term 72,73,90,91 and may increase, rather than decrease socioeconomic inequalities in oral health.[92][93][94]”
From Ending the neglect of global oral health: time for radical action. (2019) · cites this paper as [93]
Oral diseases and inequalities in oral health are caused by a complex array of individual, social, environmental, economic, political and commercial determinants, mostly shared with other NCDs.
“Oral diseases and inequalities in oral health are caused by a complex array of individual, social, environmental, economic, political and commercial determinants, mostly shared with other NCDs.”
From Ending the neglect of global oral health: time for radical action. (2019) · cites this paper as [89]
Cites
Changes in dental caries 1953–2003
Marthaler, T. M. (2004) · Caries Research · doi:10.1159/000077752 · Cited by 661 · see citing works
Fluoride mouthrinses for preventing dental caries in children and adolescents
Marinho, V. C., Higgins, J. P., Logan, S., & Sheiham, A. (2003) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002284 · Cited by 395 · see citing works
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Ending the neglect of global oral health: time for radical action.
Watt, R. G., Daly, B., Allison, P., Macpherson, L. M. D., Venturelli, R., Listl, S., Weyant, R. J., Mathur, M. R., Guarnizo-Herreño, C. C., Celeste, R. K., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(19)31133-x · Cited by 1,029 · see citing works
- Authors
- Qadri, G., Alkilzy, M., Franze, M., Hoffmann, W., & Splieth, C.
- Affiliations
- Universität Greifswald (DE)
- Venue
- Community Dental Health
- Publisher
- SAGE Publications
- Published
- 2018-08
- Volume
- 35
- Issue
- 03
- Pages
- 153-159
- ISSN
- 0265-539X (ISSN-L)
- 2515-1746
- OpenAlex
- W2909031222
- Cited by
- 34
- References
- 2
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 8 · 2020: 3 · 2019: 5
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Community Dental Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Keywords
- school-based oral health education, dental caries, caries incidence, socioeconomic disparities, socioeconomic status, elementary school students, oral health promotion, parental socioeconomic status
- MeSH terms
- Child, Dental Caries, Female, Germany, Health Education, Dental, Humans, Male, Oral Health, Social Class
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