An education intervention to improve oral health knowledge and behaviour in learners: A cluster randomized controlled trial

Introduction: Preventive dental services are required to reduce the burden of caries and oral disease in children. Objective: To assess the efficacy of three, as opposed to one, oral health education lessons in influencing the oral health related behaviour and knowledge in Grade 5 learners. study Design: Cluster randomized controlled trial. Methods: Participants: Ten public primary schools (5 intervention, 5 control) in Verulam; 337 grade 5 learners in each arm. Control arm: Viewing of an oral health education video. Intervention arm: As above repeated at three month intervals over nine months. Randomisation: At cluster level; schools randomly assigned to intervention and control arm after consent was obtained from individual participants; therefore participants remained blinded to which arm of the study they were assigned. results: A significant improvement in oral health knowledge and practice was noted for both groups after the intervention (p < 0.05). However, the intervention group returned significantly better results compared with the control for all categories except toothbrush ownership, brushing frequency and knowledge of when to replace toothbrushes. conclusion: Repeated education resulted in significant improvements in the knowledge and oral health behaviour of learners compared with the responses after one oral health lesson. INTRODUCTION Dental caries is the most common childhood disease, affecting between 60 and 90% of all five-year olds throughout the world, negatively impacting on the quality of life of the child, restricting activities, reducing ability to learn and increasing the frequency of absenteeism from schools.1,2 Children with caries may need emergency dental visits or even hospitalization, which impacts on the parents’ financial wellbeing, including time taken off work.2 The shortage of oral health professionals and fully equipped dental facilities in the public sector limits the availability of treatment services.3 Emergency relief of pain and sepsis is the most commonly performed clinical procedure at primary oral health care facilities.3,4 The burden of unmet treatment need can be significantly lowered by efforts to promote oral health and prevent the development of caries.4 Insufficient emphasis is placed on basic primary preventative oral health care and oral health education which would reduce the need for curative treatment among children at primary school age.3 In 2001, the South African (SA) Department of Health (DoH) proposed that at least 50% of all primary schools should be participants in organized preventive programmes by 2004.5 However, school-based oral health education programmes are erratic in distribution and implementation, and lack regular follow up and formal evaluation.3,6 According to data of the Health Professions Council of South Africa (HPCSA) there were 5320 registered dentists in 2010, but only 828 (15%) were working in the public sector.5,7,8 However, only 9.7 million (18%) of the 51 million people in SA9 were insured by private medical aids and therefore had access to private dental care.10,11 Nirvada Niranjan: 1. BDS (Wits), MPH (UKZN). Manager of Coding and Nomenclature, SADA. stephen Knight: 2. MBBCh, FCPHM(SA), Public Health Medicine Physician and Senior Lecturer, Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa. corresponding author Nirvada Niranjan: Cell: 084 555 6581. E-mail: nniranjan@sada.co.za saDJ May 2017, Vol 72 no 4 p167 p172 N Niranjan1, s Knight2 An education intervention to improve oral health knowledge and behaviour in learners: A cluster randomized controlled trial.