INTRODUCTION

▸ School plays an important role, not only in reaching out to

the children but also their parents and through them to the
community.

▸ In 1995, Global School Health Initiative was launched by

WHO which claims to promote and improve oral health
and also the education related activities.

▸ The core objective of this Initiative is to build capacities to

commend for improved school health programs.
▸ In 2002, World Health Organization (WHO)
recommended “schools” to be used effectively as setting
oral health promotions as they may be considered as an
ideal platform for promoting oral health.

▸ At the global level, approximately :

○ 80% of children attend primary schools
○ 60% complete at least 4 years of education, with wide
variations between countries and gender.
○ In some countries, more than 50% of children aged 7–
14 years are out of school and <20% complete the first
grade due to the exploitation of child labor.
 Major Components of the Educational Process

Educator

▸ Should send clear message

▸ Should select the learning format that matches the

objectives and goals of the program and adapt to the
learning need of the recipient

▸ Organize learning experiences incorporating the principles

of continuity, sequence and integration

▸ Encourage participatory learning, provide evaluation and

feedback
Learner

▸ The following factors that can influence a learner should be

kept in mind:

▸ Socio-demographic factors (e.g., age, sex, race/culture,

income)

▸ Values, attitudes, beliefs

▸ Readiness to change behaviors

▸ Education

▸ Cultural norms

▸ Cultural values/expectations
 Importance of Oral Health

▸ Annually more than 50 million active school hours are lost

from due to oral diseases.

▸ Though dental caries and gingival diseases are most commonly

seen among schoolchildren worldwide, other oral diseases or
conditions like dental trauma, developmental dental defects,
erosive conditions and oral cancer are of great clinical
significance.
▸ Premature loss of deciduous dentition due to dental
caries or any other reasons lead to malocclusion of the
permanent dentition, thus causing a detrimental effect
on the facial appearance of a child.

▸ Early tooth loss to affects the nutritional intake of a

child which affects the growth and development.
 INCREMENTAL DENTAL CARE

▸ It consists of providing necessary dental care for the lowest

age-group in the priority scale in 1st year, then adding a new
group to the group receiving care, each year.

▸ It may be defined as periodic care, spaced in such a way that

increments of dental disease are treated at the earliest time
possible, consisting of proper diagnosis and operating
efficiency, in such a way that there is no accumulation of
dental needs beyond minimum.
 COMPREHENSIVE DENTAL CARE

▸ Comprehensive dental care is the meeting of

accumulated dental needs at the time the population
group is taken into the program (initial care) and the
detection and correction of new increments of dental
disease on a semiannual or other periodic basis
(maintenance care).
 Various School Dental Health Programs
1. Learning about Your Oral Health
▸ This is a prevention oriented school programme. It was
developed by the ‘American Dental Association (ADA)

▸ ‘Learning about Your Oral Health’ is a comprehensive

programme covering current dental concepts.

▸ The primary goal of this programme is to develop the

knowledge, skills and attitudes needed for prevention of dental
diseases. The main aim of the programme is to develop
adequate plaque control skills and knowledge among the
school children.
2. Texas State-wide Preventive Dentistry Programme-
‘Tattle tooth Programme

▸ It was developed in 1974–1976 as a cooperative effort

between health professional organizations, the Texas
Department of Health and the Texas Education Agency.

▸ In 1985, the Texas legislature mandated the essential

elements for comprehensive health education identified in
the school health education evaluation project to be
incorporated into the state’s school children. This
stimulated the need for the “Tattle tooth program”
statewide.
▸ In May 1987, an advisory committee recommended that a
new programme be developed to replace the existing
Tattletooth Programme.

▸ The committee developed a model and with input from the

regional staff formulated a scope and sequence chart and
the lesson format. The curriculum was developed
according to a systematic process of educational
development that began with recognition and analysis of
the needs.
▸ The first videotape familiarizes the teachers with the lesson
format and content. A second videotape explains about
brushing and flossing and third videotape gives additional
background information.

▸ A two hour training session using the materials in the new

curriculum was televised to the schools via a video
network. The Texas Department of health employed 16
hygienists in the eight public health regions to implement
the program.
 3. Askov Dental Demonstration

▸ Askov is a small farming community with a population

mostly of Danish extraction. It showed very high dental
caries in the initial surveys made in 1943 and 1946.

▸ During the period from 1949 to 1957, the Section on

Dental Health of the Minnesota Department of Health
supervised a demonstration school dental health
programme in Askov, including caries prevention and
control, dental health education and dental care.
 4. North Carolina State-wide Preventive Dental
Health Programme

▸ North Carolina has a long history of involvement in dental

public health and school dental health education.

▸ In 1918, the first scientific paper addressing the need for a

school dental health education programme was presented to
the North Carolina Dental Society.

▸ In 1970, this society passed resolutions advocating a strong

preventive dental disease programme embracing school and
community fluoridation, fluoride treatments for
schoolchildren, continuing education on prevention for
dental professionals.
 5.The Bright Smiles, Bright Future

▸ Both the IDA and Colgate, have been partnering for over 25
years for awareness generation programme.

▸ Latest in the series was "The Bright Smiles, Bright Future" has
been mounted under the aegis of NOHCP (National Oral health
Care Programme) from July 2003,targeting 45 lakhs school
children across India.

▸ It has been ritual to distribute "Colgate paste and brush" free to

teachers and school children, shown as an activity of State or
local IDA branch for teachers training and promotion of oral
health.
▸ It has seldom ensured follow up activities as to what
happens to these "Colgate Pastes".

▸ Whether this activity has led to change in behaviour of

cleaning teeth or not is questionable.

▸ Tracking of teachers and students exposed to such

campaigns is seldom ensured and communication
needs on oral health are seldom assessed for effective
communication.
 6. Preschool Dental Health Programme

The preschool years are a critical period in the

development of a healthy child.

▸ Preschool children can be reached through Department of

Health Baby clinics, necessary schools, day-care centres
and kindergarten classes.

▸ a. Head Start : In 1965, Head Start, a national preschool

programme, was initiated in the United States under the
Economic Opportunity Act of 1964 to provide early
learning experiences to poor and underprivileged children.
 b. Smiling for Life

▸ The nutritional survey (1995) of British preschool

children showed that the consumption of non-milk
extrinsic sugars (NMES) was significantly higher at
19 % of total energy, than the 10 % recommended
level. The main sources of NMES in British.
 7. New Zealand Programme

▸ The New Zealand School Dental Service Plan has been

successful in influencing parents to enrole their children ‘before
reaching school age’ and in persuading children to attend
cheerfully and accept the required treatment.

▸ From its inception the service has emphasized dental health

education. The importance of early care has been stressed.

▸ For more than 25 years, promotion of the use of services by

preschool children has been a primary health education
objective. Once caries has been established, it is progressive,
unhealing and irreversible.
 8 .School Health Additional Referral Programme

▸ A programme called SHARP was instituted in

Philadelphia where the lowest rate for correction of
physical defects prevailed.

▸ The purpose of the programme was to motivate parents

into initiating action for correction of defects in their
children through effective utilization of community
resources.
▸ The project was carried out by the district nurses with
the cooperation of all school personnel. The nurses
made daytime visits to families in which the mothers
were at home. Working parents were contacted by
phone.

▸ The one-to-one basis of health guidance between

parent and health worker establishes better rapport
between school and home.
Future Recommendations for School Dental Health
Program in India

The following recommendations should be incorporated in

school health program in India.

1. The government should incorporate dental surgeons in

school health programs to give lecture on oral health, oral
hygiene, plaque control, oral and dental diseases, oral
cancer or smokeless tobacco use and hazards counseling
and topical fluoride application.

2. The government should incorporate oral and dental

health related topic in School curriculum.
3. Compulsory fitness regarding oral and dental health should
be made mandatory for class promotion. Dental Surgeons play
an important role in recognizing child abuse in school set up.

4. Dentists should evaluate child abuse cases and child abuse

cases will present clinically as physical abuse, neglect, sexual
abuse and emotional abuse.

5. The straight path to accomplish the above goals is achieved

through strong support from policy makers and professional
support from dental surgeons working in public and private
sector in India.
THE END