A study to evaluate the impact of a 21-day school brushing intervention on the knowledge, behaviour and oral health of schoolchildren (Preprint)
BACKGROUND The World Health Organization reports that dental cavities affect 60-90% of children globally. FDI World Dental Federation and Unilever Oral Care have developed public health programmes to improve brushing habits over their 12-year partnership. The last of these (Phase III) named Brush Day & Night aimed to educate children in brushing twice daily with a fluoride toothpaste. OBJECTIVE In Phase IV of the partnership, we aim to evaluate the impact on the knowledge, behaviour and toothbrushing habits in schoolchildren aged 6-9 years old, after a 21-day school programme and compare with baseline and a control group. The enduring nature of the programme will be determined by the inclusion of 8 and 24-week time points. METHODS The study is a two-arm, parallel, stratified, cluster randomized trial. Clusters in this study are infant and junior schools in Indonesia and Nigeria. The study aims to recruit 20 schools in each country. At baseline, children in both intervention and control schools will complete questionnaires and have their oral health assessed via the Simplified Oral Hygiene Index (OHIs) and Decayed Missing and Filled Teeth (DMFT). Children in the intervention schools will then take part in a structured 21-day Brush Day & Night intervention. The Brush Day & Night programme is an intense education activity designed to establish the habit of brushing day and night with a fluoride toothpaste. The programme involves daily brushing instruction and includes free toothpaste and toothbrushes. Children in the control schools will be provided with free toothpaste and toothbrushes but will not receive the 21-day intervention. The questionnaires and OHIs assessment are repeated after 21 days and then again at 8 weeks and 24 weeks later for all participating children. Parents/Carers/Guardians of all children will complete questionnaires on their own experience and attitudes to oral health and toothbrushing routine at each of the four times points (baseline, 21-day, 8 weeks and 24 weeks). The study will be conducted by the National Dental Associations of Indonesia and Nigeria. RESULTS The study is ongoing. Recruitment of schools started in Indonesia in February 2018 and in Nigeria in April 2018 for the first part of the study. This concluded in Indonesia in September 2018 and in Nigeria in November 2018. The second part of the study (the second half of the schools) started in November 2018 in Indonesia and December 2018 in Nigeria. CONCLUSIONS We expect to publish findings from the study by March 2020.