School Oral Health Intervention in Nepal
Condition: Dental Diseases
MeSH terms: Stomatognathic Diseases
Study type: Interventional

Summary: 
      Oral health problems in school children are highly prevalent in Nepal. The investigators
      designed oral health counseling and promotion intervention in Kaski district of Nepal for six
      months. The study was conducted intervention covering dental check up, counseling, supporting
      with brush materials, toothpaste, and essentials. The investigators also trained school
      teachers to provide oral health education in school children and completed the endline data
      collection to assess the effect of intervention.
    

Detailed description: 
      Globally oral health diseases are common health problems in children. About 60-90% of school
      children are suffering from dental caries worldwide . Dental caries is the most prevalent
      condition included in the 2016 Global Burden of Disease Study, ranking the first for the
      decay of permanent teeth (2.3 billon people) and 12th for deciduous teeth (560 million
      children). The dental caries process begins with a small patch of demineralized (softened)
      enamel at the tooth surface and the destruction then spreads into the softer, sensitive part
      of the tooth beneath enamel (dentin).

      Common oral diseases among children are dental caries and periodontal diseases . Pain from
      teeth or mouth can compromise their concentration and their participation in school, thereby
      hampering not only their play and development but also denying them the full benefit of
      schooling. In addition, such oral health problems negatively affect a child in restricting
      their activities, reducing the ability to learn, and increasing the frequency of absenteeism
      from schools . The most common cause of the dental problem is due to lack of dental health
      education, negligence of treatment in an early stage. Children do not have the knowledge to
      choose proper toothpaste and brush which plays an important role to maintain their oral
      hygiene and prevention dental caries. To improve oral health conditions proper awareness
      level plays an important role. Also, the proper method of tooth brushing plays an important
      role to maintain oral health status.

      A national Pathfinder Survey. However, there is no evidence in higher grade children in
      schools. The problem is grave in school children and little or no interventions targeting
      children have been practiced in Nepal.

      Therefore, designing an effective intervention that addresses knowledge and behavior on oral
      health targeting school children is necessary because they are the most at-risk population of
      oral health problems in Nepal and elsewhere. The overall aim of this study is to assess the
      effect of oral health promotion and counseling interventions on knowledge and oral hygiene
      practices in school children in Pokhara, Nepal.

      A cluster randomized control trial study will be conducted in selected community schools of
      Kaski District of Nepal. We will select six schools for the intervention group and six
      schools for the control group. The study sample will be the school students in the selected
      schools of 7 and 8 Grades. The sampling frame will be determined after preparing the list of
      students totaling of 580 students (Intervention:290; Control:290). The investigator will
      measure students' demographic characteristics, knowledge, and practices in oral health. The
      study will be conducted one year of an intervention comprising oral health screening and
      counseling every three months in the intervention group and will examine the effect of
      school-based intervention after one year of intervention. This study is expected to provide
      evidence to develop strategies for oral health promotion in community schools in Nepal.
    

Intervention name(s): Oral Health Counseling and promotion
Intervention type(s): Behavioral
Intervention description(s): The intervention was cluster randomized control trial in design. We select six schools for the intervention group and six schools for the control group. Follow-up of the intervention was done after six months of baseline. Impact of the intervention was assessed among the same participants who enrolled in the baseline. The interventions were done in every three months.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: The intervention will target school teachers and school children for counseling and oral health promotion education
Masking: Single (Participant)
Primary purpose: Prevention