A cluster randomized controlled trial testing the effectiveness of a school-based dental health education program for adolescents

Objectives: This trial investigated the value of a school-based dental heal th education program in terms of changes in knowledge, reported behavior, a nd plaque scores. Methods: A total of 2,678 pupils with a mean age of 12.1 years attending 28 schools participated in a school-based dental health edu cation program. The study used a cluster randomized controlled study design . The health service administrators stipulated that all participants receiv e the intervention; to meet this requirement, a rolling program of two six- month periods was utilized During the first six months half the adolescents received the intervention program, the other half acting as controls. Thro ughout a further six-month period, all participants received the interventi on program, This research design allowed comparisons between participants r eceiving the program for six and 12 months. At baseline, six, and 12 months , a random subsample of 40 children in each participating school had their plaque scores recorded and a questionnaire was used to record their knowled ge of dental health and reported dental behavior. Results: The analysis use d the subjects clustered within the schools, which were the units of random ization. The intervention program produced statistically significant improv ements (P<.001) in knowledge about periodontal disease and the frequency of sugar intake and dental caries in both assessment time periods. The report ed frequency of brushing did not change, but the group who had received 12 months of the intervention were more likely (P<.05) to brush for over a min ute. At six months the early intervention group had a statistically signifi cant, 13 percent reduction in the mean proportion of sites with plaque comp ared with the late intervention group (P=.043). This difference was sustain ed at 12 months (P=.037). Conclusion: This cluster randomized control trial demonstrated that the intervention program resulted in an improvement in k nowledge of denial disease and an increase in the reported duration of brus hing. These improvements were accompanied by a significant improvement in o ral hygiene and a reported reduction in gingival bleeding.