Educational Intervention of Improve Student's Oral Health: A Systematic Review and Meta-Analysis School-Based
Abstract
Background: The present research aimed to assess the effects of oral health intervention programs at school level on students’ oral hygiene in developing countries. To this aim, a systematic review and meta-analysis approach was employed.
Methods: The present research was done by surfing electronic databases with MEDLINE Ovid (Embase Ovid, Scopus), Web of Science from 2000 to Mar 2020. The data were collected using a standard type of data collection including specific studies to observational ones, and the data entered RevMan 2014. The eligibility criteria were individually randomized controlled trials (RCTs) or cluster-RCTs including quasi- experimental papers with oral health interventions. The RevMan 2014 package was used for a meta-analysis done through random-effects models.
Results: Meta-analyses revealed statistically significant divergences in terms of knowledge (SMD 3.31, 95% CI 2.52 to 4.11; I2 = 98; P<0.001), attitude (SMD 1.99, 95% CI 0. 43 to 3.54; I2 = 99; P<0.001), behavior (SMD 4.74, 95% CI 3.70 to 5.77; I2 = 99; P<0.001), plaque index (SMD -1.01, 95% CI -1.50 to -0. 51; I2 = 97; P<0.001) and Gingival index (SMD 0. 33, 95% CI -0. 36 to 1. 02; I2 = 98; P=0.34) in the case of students who received educational interventions versus those with ordinary care.
Conclusion: The present findings attested to the effectiveness of the educational interventions in improving oral health knowledge, attitudes, behaviors, and so on which can presumably contribute to a better oral hygiene, lower incidence of oral diseases, and lower costs of the treatments imposed by oral diseases.
1. Ghaffari M, Rakhshanderou S, Safari‐Moradabadi A, Torabi S (2018). Oral and dental health care during pregnancy: Evaluating a theory‐driven intervention. Oral Dis, 24:1606-1614.
2. Haque SE, Rahman M, Itsuko K, et al (2016). Effect of a school-based oral health education in preventing untreated dental caries and increasing knowledge, attitude, and practices among adolescents in Bangladesh. BMC Oral Health, 16:44.
3. Ghaffari M, Rakhshanderou S, Ramezankhani A, et al (2020). Protocol of the TOHLA instrument: A Test of Oral Health Literacy in Adults. J Educ Health Promot, 9:11.
4. Falahi A, Nematshahrbabaki B (2015). Determinants of dental health behaviors among Iranian students. Health Education and Health Promotion, 3:15-24.
5. Murphey C (2013). Oral health experiences of pregnant and parenting adolescent women: a qualitative descriptive study. Int J Nurs Stud, 50:768-775.
6. Wang T-F, Huang C-M, Chou C, Yu S (2015). Effect of oral health education programs for caregivers on oral hygiene of the elderly: A systemic review and meta-analysis. Int J Nurs Stud, 52(6):1090-1096.
7. Safari‐Moradabadi A, Rakhshanderou S, Ramezankhani A, Ghaffari M (2022). Explaining the concept of oral health literacy: Findings from an exploratory study. Community Dent Oral Epidemiol, 50(2):106-114.
8. Vos T, Abajobir AA, Abate KH, et al (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390(10100):1211-1259.
9. Balasubramanian M, Brennan D, Fox C, Hewett S (2015). Oral health challenges. In. Ed(s): FDI World Dental Federation.
10. Bracksley-O’Grady SA, Dickson-Swift VA, Anderson KS, Gussy MG (2015). Health promotion training in dental and oral health degrees: a scoping review. J Dent Educ, 79:584-591.
11. Marcenes W, Kassebaum NJ, Bernabé E, et al (2013). Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res, 92:592-597.
12. Ahmad M (2019). Effectiveness of Health Education to Improve Oral Care of Primary School Children in a Rural Community of Pakistan. EC Dent Sci, 18:01-09.
13. Petersen PE, Bourgeois D, Ogawa H, et al (2005). The global burden of oral diseases and risks to oral health. Bull World Health Organ, 83:661-669.
14. Stein C, Santos NML, Hilgert JB, Hugo FN (2018). Effectiveness of oral health education on oral hygiene and dental caries in schoolchildren: Systematic review and meta‐analysis. Community Dent Oral Epidemiol, 46:30-37.
15. Ghaffari M, Rakhshanderou S, Ramezankhani A, et al (2020). Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties. BMC Oral Health, 20:186.
16. Ghaffari M, Rakhshanderou S, Ramezankhani A, et al (2018). Oral health education and promotion programmes: meta‐analysis of 17‐year intervention. Int J Dent Hyg, 16:59-67.
17. Kay E, Locker D (1998). A systematic review of the effectiveness of health promotion aimed at improving oral health. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. Ed(s): Centre for Reviews and Dissemination (UK).
18. Deeks JJ, Higgins J, Altman DG, Green SJTCC (2011). Cochrane handbook for systematic reviews of interventions version 5.1. 0 (updated March 2011).2.
19. Andarkhora F, Bohrani M, Goodarzi A (2018). Comparison of the Effect of Lecture and Multimedia Screening on Oral Health Behavior of Students in Tehran. Military Caring Sciences Journal, 4:213-20.
20. Hassani L, Aghamolaei T, Ghanbarnejad A, et al (2016). The effect of educational intervention based on BASNEF model on the students' oral health. Journal of Research & Health, 5(4): 36-44
21. Chandrashekar BR, Suma S, Sukhabogi JR, et al (2014). Oral health promotion among rural school children through teachers: an interventional study. Indian J Public Health, 58:235-240.
22. Ganapathi AK, Namineni S, Vaakavaaka PH, et al (2015). Effectiveness of various sensory input methods in dental health education among blind children- a comparative study. J Clin Diagn Res, 9(10):ZC75-8.
23. Khudanov B, Jung HI, Kahharova D, et al (2018). Effect of an oral health education program based on the use of quantitative light-induced fluorescence technology in Uzbekistan adolescents. Photodiagnosis Photodyn Ther, 21:379-384.
24. Sadana G, Gupta T, Aggarwal N, et al (2017). Evaluation of the Impact of Oral Health Education on Oral Hygiene Knowledge and Plaque Control of School-going Children in the City of Amritsar. J Int Soc Prev Community Dent, 7:259-263.
25. Mohamadkhah F, Shokravi FA, Faghihzadeh S, Ghaffarifar S (2013). The effect of digital media programs on the oral health promotion in the health office: A quasi-experimental study. Shiraz E-Med J, 14(1): 2-12.
26. Yazdani R, Vehkalahti MM, Nouri M, Murtomaa H (2009). School-based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran. Int J Paediatr Dent, 19:274-281.
27. Haleem A, Siddiqui MI, Khan AA (2012). School-based strategies for oral health education of adolescents--a cluster randomized controlled trial. BMC Oral Health, 12:54.
28. Vangipuram S, Jha A, Raju R, Bashyam M (2016). Effectiveness of peer group and conventional method (Dentist) of oral health education programme among 12-15 year old school children - A randomized controlled trial. J Clin Diagn Res, 10(5):ZC125-9.
29. D'Cruz AM, Aradhya S (2013). Impact of oral health education on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city. Int J Dent Hyg, 11:126-33.
30. Glanz K, Rimer BK, Viswanath K (2008). Health behavior and health education: theory, research, and practice. ed. John Wiley & Sons.
31. Yang YH, Sue RL, Warnakulasuriya S, Dasanayake AP (2009). Promoting better oral health practices among aboriginal Taiwanese adolescents: A school based oral health education intervention program. J Health Care Poor Underserved, 20(4 Suppl):41-50.
32. Kay E, Locker D (1996). Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol, 24:231-235.
33. Pieper K, Weber K, Margraf-Stiksrud J, et al (2012). Evaluation of an intensified preventive programme aimed at 12-year-olds with increased caries risk. J Public Health, 20:151-157.
34. Nakre PD, Harikiran A (2013). Effectiveness of oral health education programs: A systematic review. J Int Soc Prev Community Dent, 3(2):103-15.
35. Rong WS, Bian JY, Wang WJ, De Wang J (2003). Effectiveness of an oral health education and caries prevention program in kindergartens in China. Community Dent Oral Epidemiol, 31:412-416.
36. Vachirarojpisan T, Shinada K, Kawaguchi Y (2005). The process and outcome of a programme for preventing early childhood caries in Thailand. Community Dent Health, 22:253-259.
37. Alsada LH, Sigal MJ, Limeback H, et al (2005). Development and testing of an audio-visual aid for improving infant oral health through primary caregiver education. J Can Dent Assoc, 71:241, 241a-241h.
38. Kowash M, Pinfield A, Smith J, Curzon M (2000). Dental health education: effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J, 188: 201–205.
39. Aljanakh M, Siddiqui AA, Mirza AJ (2016). Teachers’ knowledge about oral health and their interest in oral health education in Hail, Saudi Arabia. Int J Health Sci (Qassim), 10(1): 87–93.
40. Asgari I, Tabatabaei Fakhar M (2018). Attitude toward Tooth Brushing and the Validity of the Questionnaire Based on Self-efficacy in Brushing in the 13-15 Years Adolescents in Isfahan, Iran. J Mashhad Dent Sch, 42:329-339.
41. Åstrøm AN (2012). Changes in oral health related knowledge, attitudes and behaviours following school based oral health education and atraumatic restorative treatment in rural Tanzania. Nor Epidemiol, 22 (1): 21-30.
42. Al Subait AA, Alousaimi M, Geeverghese A, Ali A, El Metwally A (2016). Oral health knowledge, attitude and behavior among students of age 10–18 years old attending Jenadriyah festival Riyadh; a cross-sectional study. Saudi J Dent Res, 7:45-50.
43. Sukhabogi JR, Shekar BC, Hameed IA (2014). Knowledge, attitude and practices related to oral health among English and Telugu medium school teachers in two districts of Andhra Pradesh, India: a comparative study. J Public Health Dent, 12 (4):306-311.
44. Solhi M, Zadeh DS, Seraj B, Zadeh SF (2010). The application of the health belief model in oral health education. Iran J Public Health, 39:114-119.
45. Yekaninejad MS, Eshraghian MR, Nourijelyani K, et al (2012). Effect of a school‐based oral health‐education program on I ranian children: results from a group randomized trial. Eur J Oral Sci, 120:429-437.
46. Pakpour AH, Yekaninejad MS, Sniehotta FF, et al (2014). The effectiveness of gain-versus loss-framed health messages in improving oral health in Iranian secondary schools: a cluster-randomized controlled trial. Ann Behav Med, 47:376-387.
47. Blake H, Dawett B, Leighton P, et al (2015). School-based educational intervention to improve children’s oral health–related knowledge. Health Promot Pract, 16:571-582.
48. Prabhu S, John J (2015). Oral health education for improving oral health status of school children a systematic review. IOSR J Dent Med Sci, 14:101-106.
2. Haque SE, Rahman M, Itsuko K, et al (2016). Effect of a school-based oral health education in preventing untreated dental caries and increasing knowledge, attitude, and practices among adolescents in Bangladesh. BMC Oral Health, 16:44.
3. Ghaffari M, Rakhshanderou S, Ramezankhani A, et al (2020). Protocol of the TOHLA instrument: A Test of Oral Health Literacy in Adults. J Educ Health Promot, 9:11.
4. Falahi A, Nematshahrbabaki B (2015). Determinants of dental health behaviors among Iranian students. Health Education and Health Promotion, 3:15-24.
5. Murphey C (2013). Oral health experiences of pregnant and parenting adolescent women: a qualitative descriptive study. Int J Nurs Stud, 50:768-775.
6. Wang T-F, Huang C-M, Chou C, Yu S (2015). Effect of oral health education programs for caregivers on oral hygiene of the elderly: A systemic review and meta-analysis. Int J Nurs Stud, 52(6):1090-1096.
7. Safari‐Moradabadi A, Rakhshanderou S, Ramezankhani A, Ghaffari M (2022). Explaining the concept of oral health literacy: Findings from an exploratory study. Community Dent Oral Epidemiol, 50(2):106-114.
8. Vos T, Abajobir AA, Abate KH, et al (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390(10100):1211-1259.
9. Balasubramanian M, Brennan D, Fox C, Hewett S (2015). Oral health challenges. In. Ed(s): FDI World Dental Federation.
10. Bracksley-O’Grady SA, Dickson-Swift VA, Anderson KS, Gussy MG (2015). Health promotion training in dental and oral health degrees: a scoping review. J Dent Educ, 79:584-591.
11. Marcenes W, Kassebaum NJ, Bernabé E, et al (2013). Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res, 92:592-597.
12. Ahmad M (2019). Effectiveness of Health Education to Improve Oral Care of Primary School Children in a Rural Community of Pakistan. EC Dent Sci, 18:01-09.
13. Petersen PE, Bourgeois D, Ogawa H, et al (2005). The global burden of oral diseases and risks to oral health. Bull World Health Organ, 83:661-669.
14. Stein C, Santos NML, Hilgert JB, Hugo FN (2018). Effectiveness of oral health education on oral hygiene and dental caries in schoolchildren: Systematic review and meta‐analysis. Community Dent Oral Epidemiol, 46:30-37.
15. Ghaffari M, Rakhshanderou S, Ramezankhani A, et al (2020). Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties. BMC Oral Health, 20:186.
16. Ghaffari M, Rakhshanderou S, Ramezankhani A, et al (2018). Oral health education and promotion programmes: meta‐analysis of 17‐year intervention. Int J Dent Hyg, 16:59-67.
17. Kay E, Locker D (1998). A systematic review of the effectiveness of health promotion aimed at improving oral health. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. Ed(s): Centre for Reviews and Dissemination (UK).
18. Deeks JJ, Higgins J, Altman DG, Green SJTCC (2011). Cochrane handbook for systematic reviews of interventions version 5.1. 0 (updated March 2011).2.
19. Andarkhora F, Bohrani M, Goodarzi A (2018). Comparison of the Effect of Lecture and Multimedia Screening on Oral Health Behavior of Students in Tehran. Military Caring Sciences Journal, 4:213-20.
20. Hassani L, Aghamolaei T, Ghanbarnejad A, et al (2016). The effect of educational intervention based on BASNEF model on the students' oral health. Journal of Research & Health, 5(4): 36-44
21. Chandrashekar BR, Suma S, Sukhabogi JR, et al (2014). Oral health promotion among rural school children through teachers: an interventional study. Indian J Public Health, 58:235-240.
22. Ganapathi AK, Namineni S, Vaakavaaka PH, et al (2015). Effectiveness of various sensory input methods in dental health education among blind children- a comparative study. J Clin Diagn Res, 9(10):ZC75-8.
23. Khudanov B, Jung HI, Kahharova D, et al (2018). Effect of an oral health education program based on the use of quantitative light-induced fluorescence technology in Uzbekistan adolescents. Photodiagnosis Photodyn Ther, 21:379-384.
24. Sadana G, Gupta T, Aggarwal N, et al (2017). Evaluation of the Impact of Oral Health Education on Oral Hygiene Knowledge and Plaque Control of School-going Children in the City of Amritsar. J Int Soc Prev Community Dent, 7:259-263.
25. Mohamadkhah F, Shokravi FA, Faghihzadeh S, Ghaffarifar S (2013). The effect of digital media programs on the oral health promotion in the health office: A quasi-experimental study. Shiraz E-Med J, 14(1): 2-12.
26. Yazdani R, Vehkalahti MM, Nouri M, Murtomaa H (2009). School-based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran. Int J Paediatr Dent, 19:274-281.
27. Haleem A, Siddiqui MI, Khan AA (2012). School-based strategies for oral health education of adolescents--a cluster randomized controlled trial. BMC Oral Health, 12:54.
28. Vangipuram S, Jha A, Raju R, Bashyam M (2016). Effectiveness of peer group and conventional method (Dentist) of oral health education programme among 12-15 year old school children - A randomized controlled trial. J Clin Diagn Res, 10(5):ZC125-9.
29. D'Cruz AM, Aradhya S (2013). Impact of oral health education on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city. Int J Dent Hyg, 11:126-33.
30. Glanz K, Rimer BK, Viswanath K (2008). Health behavior and health education: theory, research, and practice. ed. John Wiley & Sons.
31. Yang YH, Sue RL, Warnakulasuriya S, Dasanayake AP (2009). Promoting better oral health practices among aboriginal Taiwanese adolescents: A school based oral health education intervention program. J Health Care Poor Underserved, 20(4 Suppl):41-50.
32. Kay E, Locker D (1996). Is dental health education effective? A systematic review of current evidence. Community Dent Oral Epidemiol, 24:231-235.
33. Pieper K, Weber K, Margraf-Stiksrud J, et al (2012). Evaluation of an intensified preventive programme aimed at 12-year-olds with increased caries risk. J Public Health, 20:151-157.
34. Nakre PD, Harikiran A (2013). Effectiveness of oral health education programs: A systematic review. J Int Soc Prev Community Dent, 3(2):103-15.
35. Rong WS, Bian JY, Wang WJ, De Wang J (2003). Effectiveness of an oral health education and caries prevention program in kindergartens in China. Community Dent Oral Epidemiol, 31:412-416.
36. Vachirarojpisan T, Shinada K, Kawaguchi Y (2005). The process and outcome of a programme for preventing early childhood caries in Thailand. Community Dent Health, 22:253-259.
37. Alsada LH, Sigal MJ, Limeback H, et al (2005). Development and testing of an audio-visual aid for improving infant oral health through primary caregiver education. J Can Dent Assoc, 71:241, 241a-241h.
38. Kowash M, Pinfield A, Smith J, Curzon M (2000). Dental health education: effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J, 188: 201–205.
39. Aljanakh M, Siddiqui AA, Mirza AJ (2016). Teachers’ knowledge about oral health and their interest in oral health education in Hail, Saudi Arabia. Int J Health Sci (Qassim), 10(1): 87–93.
40. Asgari I, Tabatabaei Fakhar M (2018). Attitude toward Tooth Brushing and the Validity of the Questionnaire Based on Self-efficacy in Brushing in the 13-15 Years Adolescents in Isfahan, Iran. J Mashhad Dent Sch, 42:329-339.
41. Åstrøm AN (2012). Changes in oral health related knowledge, attitudes and behaviours following school based oral health education and atraumatic restorative treatment in rural Tanzania. Nor Epidemiol, 22 (1): 21-30.
42. Al Subait AA, Alousaimi M, Geeverghese A, Ali A, El Metwally A (2016). Oral health knowledge, attitude and behavior among students of age 10–18 years old attending Jenadriyah festival Riyadh; a cross-sectional study. Saudi J Dent Res, 7:45-50.
43. Sukhabogi JR, Shekar BC, Hameed IA (2014). Knowledge, attitude and practices related to oral health among English and Telugu medium school teachers in two districts of Andhra Pradesh, India: a comparative study. J Public Health Dent, 12 (4):306-311.
44. Solhi M, Zadeh DS, Seraj B, Zadeh SF (2010). The application of the health belief model in oral health education. Iran J Public Health, 39:114-119.
45. Yekaninejad MS, Eshraghian MR, Nourijelyani K, et al (2012). Effect of a school‐based oral health‐education program on I ranian children: results from a group randomized trial. Eur J Oral Sci, 120:429-437.
46. Pakpour AH, Yekaninejad MS, Sniehotta FF, et al (2014). The effectiveness of gain-versus loss-framed health messages in improving oral health in Iranian secondary schools: a cluster-randomized controlled trial. Ann Behav Med, 47:376-387.
47. Blake H, Dawett B, Leighton P, et al (2015). School-based educational intervention to improve children’s oral health–related knowledge. Health Promot Pract, 16:571-582.
48. Prabhu S, John J (2015). Oral health education for improving oral health status of school children a systematic review. IOSR J Dent Med Sci, 14:101-106.
| Files | ||
| Issue | Vol 52 No 3 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i3.12133 | |
| Keywords | ||
| Oral health Health promotion Intervention Systematic review Meta-analysis | ||
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How to Cite
1.
Dadipoor S, Akbarizadeh F, Ghaffari M, Alipour A, Safari-Moradabadi A. Educational Intervention of Improve Student’s Oral Health: A Systematic Review and Meta-Analysis School-Based. Iran J Public Health. 2023;52(3):500-514.
