Evaluation of a school based oral health promoting programme in Rwanda

Abstract

Evaluation of a school based oral health promoting programme in Rwanda.
Objectives: To evaluate the effect of the project on oral health, practices, knowledge and attitudes of pupils and teachers. Methods: Thirteen primary schools were included, six schools served as controls. Schoolteachers supervised handwashing and toothbrushing with fluoride toothpaste on school days, parallel with training sessions by dental therapists. Data were collected at baseline and after two years’ activities. Results: At baseline, 44% of the children had problems from their mouth. Caries prevalence in the pupils’ permanent dentition was 45%, and 64% showed gingival bleeding. About 30% cleaned their teeth twice daily, 60% washed hands at least twice daily. After two years, dental problems of project school pupils were reduced to one sixth of the baseline level, caries and gingival bleeding went down to one third or one fourth. The number of pupils brushing with fluoride toothpaste twice daily doubled. Knowledge of teachers from project schools improved by 68%, attitudes by 29%. Findings in the control groups were similar to baseline or slightly improved. The moderate improvements in the pupils’ attendance and academic performance were slightly higher in intervention schools than in control schools. Discussion: Apparently, frequent professional supervision of the teachers and involvement of district health personnel and authorities is crucial. Conclusions: With few expenses and low technology efforts it is possible within two years to implement efficient daily oral health self-care in the school setting in African countries leading to impressive improvements of health.