Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Dental Services, CLASSROOM_SCHOOL

Intervention Description: To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services.

Intervention Results: This trial evaluated a post screening referral letter based on the common-sense model of self-regulation (a theoretical framework that explains how people understand and respond to threats to their health), with or without a dental information guide, compared to a standard referral letter. The findings were inconclusive. Due to high risk of bias, indirectness and imprecision, we assessed the evidence as very low certainty.

Conclusion: The trials included in this review evaluated short-term effects of screening. We found very low-certainty evidence that is insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening, there is no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters may improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) may improve dental attendance in comparison to screening alone. For children requiring treatment, we found very-low certainty evidence that was inconclusive regarding whether or not a referral letter based on the 'common-sense model of self-regulation' was better than a standard referral letter. We did not find any trials addressing possible adverse effects of school dental screening or evaluating its effectiveness for improving oral health.

Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, School-Based Dental Services

Intervention Description: To assess the effects of an elementary school-based health center (SBHC) on access to and the use of physical and mental health services by children aged 4 to 13 years.

Intervention Results: Independent of confounders, access to a school-based health center was significantly associated with a greater likelihood of the child having received a yearly dental examination (OR=1.36, 95% CI: 1.91=1.83, p<0.05). Stratifying the sample by insurance status revealed that among insured students, a higher percentage of students in the comparison school without a school-based health center (65.0%) obtained a yearly dental examination compared to the intervention school with a school-based health center (53.4%) (p<0.05). Among uninsured students, a significantly higher percentage of those in the intervention school (36.5%) obtained a yearly dental examination compared to the comparison school (18.5%) (p<0.01).

Conclusion: Independent of insurance status and other confounding variables, underserved minority children with SBHC access have better health care access and use than children without SBHC access, signifying that SBHCs can be an effective component of health delivery systems for these children.

Study Design: QE: nonequivalent control group

Setting: One intervention school and one comparison school in Denver, CO

Population of Focus: All elementary school students (pre-K to fifth grade) enrolled in the schools

Data Source: Parent questionnaire

Sample Size: Intervention (n=728) Control (n=571)

Age Range: not specified

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Dental Services, CLASSROOM_SCHOOL, HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education

Intervention Description: This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12-14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India.

Intervention Results: The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001).

Conclusion: Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.