An oral health programme for schoolchildren in Kuwait 1986-97

Objectives To assess whether it was possible to implement an oral health pr ogramme in Kuwait which followed guidelines underlying the public Danish Ch ild Oral Health Service, and thereby improve the oral health of Kuwaiti chi ldren. Design Successive cross-sectional surveys were carried out in one go vernorate in Kuwait (Al-Ahmadi) during the period 1986-97 interrupted by th e Gulf War. Data were collected by clinical examinations. Setting The progr amme was initiated by the Ministry of Health in Kuwait in order to improve the community services through a school-based oral health care programme. P articipants The study population comprised incrementally all children in th e four primary school classes in the governorate. Interventions The childre n received biweekly tooth brushing instructions with fluoridated toothpaste and fluoride rinsing, fissure sealing, oral health education, and restorat ive treatment of dental caries. Outcome measures The children were clinical ly examined each year before the start of the treatment. Dental caries was scored at surface level in accordance with the Danish registration system, using the WHO criteria for dental caries. Results The average participation rate was 94%. The percentage of caries-free children, exemplified by secon d class, increased from 64% in 1987 to 78% in 1990, dropped to 71% in 1992 and increased again to 79% in 1997. Conclusion It is concluded that it has been possible to adapt the principles from the Danish Child Oral Health Ser vice programme to Kuwait, that parents and teachers accepted the principle of treating the children during school hours, and that the oral health of t he children improved. Whether the improvement in the oral health is due to the programme or to changes in the society is discussed.