Cochrane Summaries

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Programmes based in primary schools designed to help prevent tooth decay by changing children's behaviour

Cooper AM, O'Malley LA, Elison SN, Armstrong R, Burnside G, Adair P, Dugdill L, Pine C
Published Online: 
31 May 2013

Improving the dental health of children is a global public health priority. Currently 60% to 90% of 5-year olds worldwide suffer from tooth decay. Understanding how to intervene early with respect to establishing good dental health habits requires an understanding of the key behaviours which either help prevent decay (toothbrushing, twice a day with a fluoride-based toothpaste) or encourage decay (sugar snacking) in children's teeth. Primary schools provide a setting in which behavioural interventions designed to encourage and establish good toothbrushing and snacking habits can be tested.

This review examined how successful the interventions in the suitable studies were in improving dental health in children aged from 4 to 12 years. The latest search of relevant studies was carried out on 18th October 2012.

Interventions were programmes that enabled children to.

∙ Making lasting changes to toothbrushing habits.
∙ Reduce the amount and how often food and drink known to cause tooth decay were consumed.

The trials had to include an educational element which taught skills or gave instructions and one or more accepted techniques to change behaviour.

Out of 1518 possible studies found only four were sufficiently relevant and of high enough quality to be included in this review. One small study showed that children who received the behavioural intervention developed fewer caries during the study. Three studies showed that there was less dental plaque (better oral hygiene) in the children in the behavioural intervention groups. More research is needed to confirm these findings.

The dental health of 4 to 12 year olds is an important issue - reducing the amount of decay in this group would have a positive impact on overall health, particularly for those living in the poorest communities. More high quality research with well designed programmes will help to establish which techniques are most effective at changing child and parent behaviour to encourage good toothbrushing and discourage sugar snacking.

This record should be cited as: 
Cooper AM, O'Malley LA, Elison SN, Armstrong R, Burnside G, Adair P, Dugdill L, Pine C. Primary school-based behavioural interventions for preventing caries. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD009378. DOI: 10.1002/14651858.CD009378.pub2
Assessed as up to date: 
18 October 2012