EFFICACY OF SCHOOL-BASED ORAL HEALTH PROMOTION: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5921Keywords:
School-Based Oral Health Promotion, Dental Caries Prevention, Oral Health Education, Children and Adolescents, Plaque ControlAbstract
Childhood oral diseases, such as dental caries, remain globally prevalent. This narrative review synthesizes evidence on the efficacy of school-based oral health promotion programs for children and adolescents (aged 5–18), focusing on knowledge, oral hygiene, and caries outcomes. A literature search of PubMed/MEDLINE, Scopus, and Google Scholar was conducted for English-language systematic reviews, meta-analyses, and clinical trials evaluating school-based preventive interventions. School-based programs consistently improve oral health knowledge and achieve short-term plaque reductions; however, education alone shows limited long-term clinical impact. Sustained clinical outcomes, specifically caries reduction, require multicomponent programs integrating supervised fluoride delivery, parental involvement, and teacher-led reinforcement. Currently, the certainty of evidence remains low to moderate due to study heterogeneity and short follow-up periods. School-based oral health promotion is a viable public health strategy when implemented as a sustained, multicomponent initiative extending beyond the classroom. Future research should prioritize cost-effectiveness, standardized measures, and longer follow-ups, particularly in low- and middle-income settings.
References
Akera, P., Kennedy, S. E., Lingam, R., Obwolo, M., Schutte, A., & Richmond, R. (2022). Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: A systematic review and meta-analysis. BMC Oral Health, 22, 233. https://doi.org/10.1186/s12903-022-02291-2
Al-Jundi, S., Hammad, M. M., & Al-Waeli, H. (2006). The efficacy of a school-based caries preventive program: A 4-year study. International Journal of Dental Hygiene, 4(1), 30–34. https://doi.org/10.1111/j.1601-5037.2006.00156.x
Blake, H., Dawett, B., Leighton, P., Rose-Brady, L., & Deery, C. (2015). School-based educational intervention to improve children’s oral health-related knowledge. Health Promotion Practice, 16(4), 571–582. https://doi.org/10.1177/1524839914560568
Bramantoro, T., Santoso, C., Hariyani, N., Setyowati, D., Zulfiana, A., Nor, N., Nagy, A., Pratamawari, D. N. P., & Irmalia, W. (2021). Effectiveness of the school-based oral health promotion programmes from preschool to high school: A systematic review. PLOS ONE, 16(8), Article e0256007. https://doi.org/10.1371/journal.pone.0256007
Das, H., Janakiram, C., Kumar, V. S., & Karuveettil, V. (2025). Effectiveness of school-based oral health education interventions on oral health status and oral hygiene behaviors among schoolchildren: An umbrella review. Evidence-Based Dentistry. https://doi.org/10.1038/s41432-024-01101-8
Doshi, A., Bapna, D., Qadri, A. W., Garg, A., & Abhishek, S. D. (2024). Effectiveness of school-based oral health education programs in improving knowledge, attitude, and practice among primary school students: A pre-post intervention study. African Journal of Biomedical Research, 27(4s). https://doi.org/10.53555/ajbr.v27i4s.4637
Gasemi, H., Alautry, H. F., Khoshnevisan, M. H., & Namdari, M. (2024). Effectiveness of a school-based oral health promotion program on dental caries among Iraqi school children: A cluster randomised controlled trial. International Dental Journal. https://doi.org/10.1016/j.identj.2024.07.1214
Gauba, A., Bal, I., Jain, A., & Mittal, H. C. (2013). School-based oral health promotional intervention: Effect on knowledge, practices, and clinical oral health-related parameters. Contemporary Clinical Dentistry, 4(4), 461–465. https://doi.org/10.4103/0976-237X.123056
GeethaPriya, P., Asokan, S., & Janani, R. (2019). Effectiveness of school dental health education on the oral health status and knowledge of children: A systematic review. Indian Journal of Dental Research, 30(6), 940–947. https://doi.org/10.4103/ijdr.IJDR_805_18
Gupta, G., Mallick, S., Awasthi, A., Sharma, V., Bansal, S., & Kriti, S. (2025). Impact of school-based periodontal health education programs on gingival health in adolescents: A cluster-randomized controlled trial. Journal of Pharmacy and Bioallied Sciences. https://doi.org/10.4103/jpbs.jpbs_1040_25
Hazavehei, S. M. M., Shirahmadi, S., Taheri, M., Noghan, N., & Rezaei, N. (2015). Promoting oral health in 6–12-year-old students: A systematic review. Journal of Education and Community Health, 1(4), 66–77. https://doi.org/10.20286/JECH-010466
Khoshnevisan, M., Pakkhesal, M., Jadidfard, M., & Godarzi Nejad, G. (2017). School-based oral health promotion: A thorough review. Shahid Beheshti University Dental Journal, 35(3), 155–163.
Kim, H., & Kim, J. (2024). The computed effect size of school-based oral health education in low- and middle-income countries [Systematic review and meta-analysis].
Lawal, F., & Taiwo, J. (2017). Making a case for formal school-based oral health promotion: Oral health knowledge, attitude and practices of pupils in Ibadan, Nigeria. International Quarterly of Community Health Education, 38(1), 55–62. https://doi.org/10.1177/0272684X17749574
Narayan, V., Thomas, S., Gomez, M. S., Bhaskar, B., & Rao, A. (2023). Auxiliary delivered school-based oral health promotion among 12–14-year-old children from a low-resource setting: A cluster randomized trial. Journal of Public Health Dentistry, 83(3), 256–264. https://doi.org/10.1111/jphd.12565
Panda, S., Mohapatra, A., & Jalaluddin, M. (2025). Evaluating the effectiveness of school-based oral health education methods in improving children’s oral health: A systematic review. Bulletin of Stomatology and Maxillofacial Surgery, 21, 8–13. https://doi.org/10.58240/1829006x-2025.21.8-13
Redmond, C., Blinkhorn, F., Kay, E., Davies, R., Worthington, H., & Blinkhorn, A. (1999). A cluster randomized controlled trial testing the effectiveness of a school-based dental health education program for adolescents. Journal of Public Health Dentistry, 59(1), 12–19. https://doi.org/10.1111/j.1752-7325.1999.tb03229.x
Ruff, R., Monse, B., Duijster, D., Itchon, G., Naliponguit, E., & Benzian, H. (2022). Effectiveness of school-based strategies to prevent tooth decay in Filipino children: A cluster-randomized trial. Community Dentistry and Oral Epidemiology, 50(5), 374–383. https://doi.org/10.1111/cdoe.12729
Saied-Moallemi, Z., Virtanen, J., Vehkalahti, M., Tehranchi, A., & Murtomaa, H. (2009). School-based intervention to promote preadolescents’ gingival health: A community trial. Community Dentistry and Oral Epidemiology, 37(6), 518–526. https://doi.org/10.1111/j.1600-0528.2009.00491.x
Shakir, A., Barngkgei, I., Godson, J., & Joury, E. (2021). Effectiveness of school-based behavioural interventions to improve children’s oral health by reducing sugar intake and promoting oral hygiene: A rapid review of randomised controlled trials. Community Dental Health, 38(1), 4–12. https://doi.org/10.1922/CDH_00014Shakir09
Shekhawat, K., Chauhan, A., Devi, S., Kumar, H., & Mishra, P. (2016). School-based intervention programme on gingival health of 10–12-year-old government aided school children of Basavangudi in Bangalore City: A randomized controlled trial. Indian Journal of Public Health Research and Development, 7(1), 212–217. https://doi.org/10.5958/0976-5506.2016.00070.X
Soldani, F., & Wu, J. (2018). School-based oral health education. Evidence-Based Dentistry, 19(1), 28–29. https://doi.org/10.1038/sj.ebd.6401298
Starr, J., Ruff, R., Palmisano, J., Goodson, J. M., Bukhari, O. M., & Niederman, R. (2020). Longitudinal caries prevalence in a comprehensive, multi-component, school-based prevention program [Preprint]. medRxiv. https://doi.org/10.1101/2020.10.22.20217760
Tai, B., Jiang, H., Du, M., & Peng, B. (2009). Assessing the effectiveness of a school-based oral health promotion programme in Yichang City, China. Community Dentistry and Oral Epidemiology, 37(5), 391–398. https://doi.org/10.1111/j.1600-0528.2009.00484.x
Thomas, S., Tandon, S., & Nair, S. (2000). Effect of a dental health education program on the oral health knowledge, attitude and practice of school teachers in Udaipur, India. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 18(3), 90–96.
Tolvanen, M., Lahti, S., Poutanen, R., Seppä, L., Pohjola, V., & Hausen, H. (2009). Changes in children’s oral health-related behavior, knowledge, and attitudes during a 3.4-year randomized clinical trial and oral health-promotion program. European Journal of Oral Sciences, 117(4), 390–397. https://doi.org/10.1111/j.1600-0722.2009.00640.x
Yazdani, R., Vehkalahti, M., Nouri, M., & Murtomaa, H. (2009). School-based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran. International Journal of Paediatric Dentistry, 19(4), 274–281. https://doi.org/10.1111/j.1365-263X.2009.00972.x
Yekaninejad, M., Eshraghian, M., Nourijelyani, K., Mohammad, K., Foroushani, A., Zayeri, F., Pakpour, A., Moscowchi, A., & Tarashi, M. (2012). Effect of a school-based oral health-education program on Iranian children: Results from a group randomized trial. European Journal of Oral Sciences, 120(5), 429–437. https://doi.org/10.1111/j.1600-0722.2012.00993.x
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Dominik Stanislawski, Natalia Borek, Julia Gałązka, Ewa Stopa, Hanna Krupa, Magdalena Kędrak, Zofia Wieczorek, Emilia Miśkiewicz, Wiktoria Jabłońska-Trzosek, Jakub Pochwalski
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
How to Cite
