Evidence
This section contains a brief overview of the research carried out in this area. The evidence is divided into the settings listed here.
View overview
Oral health is an integral element of general health and wellbeing. Good oral health enables individuals to communicate effectively, to eat a variety of foods, and is important for overall quality of life, self-esteem and social confidence.
Although preventable, oral conditions such as dental caries and periodontal disease are still common, especially among the lower income and socially disadvantaged groups. Despite overall improvements in oral health, inequalities have persisted and mirror those in general health.
The impact of oral diseases on both society and the individual is significant. Pain, discomfort, sleepless nights, limitation in eating function leading to poor nutrition, and time off school or work as a result of dental problems are all common effects of oral diseases. In addition, the cost of dental treatment is high to individuals and the healthcare system. For example, in England the total spend on dental care in 2004 was £3.8 billion.
Effective preventive strategies to promote sustainable improvements in oral health are needed. These strategies need to address the underlying determinants of oral diseases and adopt a Common Risk Factor Approach (CRFA). The CRFA recognises that dental diseases share a set of common risk factors and conditions with other chronic diseases. Action therefore needs to be directed at these shared causes of poor health. Interventions that target children are likely to have the greatest long-term impact.
Promotion of good oral health in children in schools or community settings
View Methodology
Topics searched
We searched for studies on interventions to promote oral health in children (aged 18 years and under) in school or community settings.
In school settings, studies with any of the following interventions were included:
- Supervised tooth brushing interventions
- Health promoting policies in schools
- Fissure sealants
- Oral health promotion interventions (for example, games, videos, printed materials).
In community settings, studies with any of the following interventions were included:
- Fluoridation programmes
- Oral health promotion interventions (for example, games, videos, printed materials).
Studies that had only self reported outcomes that were unvalidated by another person were excluded from the review by critical appraisal.
Dates and study types searched
We searched for systematic reviews and randomised controlled trials published from 1990 until August 2006.
Databases searched
We searched Medline, Embase, Cinahl, and the Cochrane Library for relevant studies. We also searched the Trip database.
Search strategies
These are searches that have been conducted on Ovid Medline (http://gateway.ovid.com/). The other searches have been adapted from this one to accommodate the search engine of each specific database.
Community setting
1. Child/
2. teen$.ti,ab.
3. adolescen$.ti,ab.
4. child$.ti,ab.
5. health education, dental/
6. Oral Health/
7. dental health.ti,ab.
8. ((fluoridation$ adj2 water) or (fluoride adj2 water)).ti,ab.
9. oral health.ti,ab.
10. fluoridation/
11. (school$ or preschool$).ti.
12. or/1-4
13. or/5-10
14. 12 and 13
15. 14 not 11
School setting
1. Child/
2. schools/ or school$.ti,ab.
3. Oral Health/
4. dental health.ti,ab.
5. oral health.ti,ab.
6. Oral Hygiene/
7. exp Dental Care/
8. School Dentistry/
9. Health Education, Dental/
10. Toothbrushing/
11. 1 and 2
12. or/3-10
13. 11 and 12
Filter
The following filter was used to include only randomised controlled trials or systematic reviews:
1. ("review" or "review academic" or "review tutorial").pt.
2. (medline or medlars or embase).tw,sh
3. (scisearch or psychinfo or psycinfo).tw,sh.
4. (psychlit or psyclit).tw,sh.
5. cinahl.tw,sh.
6. ((hand adj2 search$) or (manual$ adj2 search$)).tw,sh.
7. (electronic database$ or bibliographic database$ or computeri?ed database$ or online database$).tw,sh
8. (pooling or pooled or mantel haenszel).tw,sh.
9. (peto or dersimonian or der simonian or fixed effect).tw,sh.
10. or/2-9 47239
11. 1 and 10
12. meta-analysis.pt.
13. meta-analysis.sh.
14. (meta-analys$ or meta analys$ or metaanalys$).tw,sh.
15. (systematic$ adj5 review$).tw,sh.
16. (systematic$ adj5 overview$).tw,sh.
17. (quantitativ$ adj5 review$).tw,sh.
18. (quantitativ$ adj5 overview$).tw,sh.
19. (quantitativ$ adj5 synthesis$).tw,sh
20. (methodologic$ adj5 review$).tw,sh.
21. (methodologic$ adj5 overview$).tw,sh.
22. (integrative research review$ or research integration).tw.
23. or/12-22
24. 11 or 23
25. exp Randomized controlled trials/
26. "randomized controlled trial".pt.
27. "controlled clinical trial".pt.
28. (random$ or placebo$).ti,ab,sh.
29. ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$)).tw,sh.
30. or/25-29
31. (animals not humans).sh.
32. 30 not 31