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 Table of Contents  
Year : 2018  |  Volume : 10  |  Issue : 1  |  Page : 1-3

Need of oral health promotion through schools among developing countries

1 Department of Dental Public Health, Riyadh ELM University, Riyadh, Saudi Arabia
2 Consultant in Prosthodontics and Dental Implant, Riyadh ELM University, Riyadh, Saudi Arabia

Date of Web Publication26-Feb-2018

Correspondence Address:
Dr. Badr Ahmed Alrmaly
Department of Dental Public Health, Riyadh ELM University, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jioh.jioh_242_17

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Schools can provide a supportive environment for promoting oral health. Schools can also provide an important network and channel to the local community. Health promotion activities can be targeted at home and throughout the community by school personnel. This school-home-community interaction is an important aspect of a health-promoting school. An effective school oral health program is one of the most cost-effective interventions a nation can make to simultaneously improve education and oral health. Therefore, there is a need of formulating appropriate and feasible strategies with an objective of promoting oral health through schools for school settings. Thus, need for oral health promotion is a very important aspect to be looked upon. Schools play a significant role in oral health promotions.

Keywords: Oral health, oral needs, school

How to cite this article:
Alrmaly BA, Assery MK. Need of oral health promotion through schools among developing countries. J Int Oral Health 2018;10:1-3

How to cite this URL:
Alrmaly BA, Assery MK. Need of oral health promotion through schools among developing countries. J Int Oral Health [serial online] 2018 [cited 2022 Jan 18];10:1-3. Available from:

  Introduction Top

Children's performance in school and in their success in life can be affected due to poor oral health. Dental caries is the most prevalent oral disease in several Asian and Latin American countries, while it appears to be less common and less severe in most African countries.[1] The occurrence of gum disease is high among older children and adolescents, with 50%–100% of 12-year-old children having the signs of gum inflammation.[2]

Upper front teeth are mainly traumatized from accidents, sport-related injuries, violence, and epilepsy. A safe environment at home, in schools, and in the community, including safer playgrounds and roads with well-organized traffic, can help minimize the risks.[3]

Recent research suggests that some adolescents begin to experience loss of control over their smoking within weeks of smoking the first cigarette.

There are also important links between oral health and general health. These studies have provided support that oral infections, specifically periodontitis, may confer independent risks for different systemic conditions (mortality, osteoporosis, diabetes mellitus, pulmonary infections, preterm low-weight births, cardiovascular diseases, and infections in other body sites). Since cardiovascular diseases are the leading cause of death worldwide, greater attention has been focused on evidence that infections of the oral cavity might be associated with atherothrombosis: heart infarction, stroke, and peripheral vascular disease.[4]

  Need for Promoting Oral Health Through Schools Top

Dental caries and periodontal disease are among all developing countries

Although dental caries in schoolchildren has declined in many industrialized countries in the past decades, dental caries has increased in many developing countries, especially those where preventive program has not been established.

According to a National Oral Health Survey and Fluoride Mapping by the Dental Council of India (2004), 51.9% of children aged 5 years, 53.8% of 12-year olds, and 63.1% of 15-year olds had dental caries. The prevalence of periodontal disease in children aged 12 years was 57%.[5]

Increasing incidence of oral lesion and conditions

Quality of life can be affected due to appearance of teeth caused by defects and color of tooth enamel. Enamel defects are rising in some countries. In Malaysia, it has been reported that over 75% of 12-year-old children have some forms of enamel defects and opacities, regardless of whether the area is fluoridated or not.[6]

Incidence of dental trauma is increasing

Each year, unintentional injuries account for more than 400,000 deaths globally, the majority in children and adolescents.

In addition, injuries tend to be more prevalent in boys. Regulatory measures, environmental changes, and education play a crucial role in the prevention of injuries and accidents in children's environments.[3]

Knowledge of oral health among teachers and parents

Studies have shown mothers with lower level of education also have a lower level of oral health-related knowledge. The improvement in oral health among children over the past decades has been attributed to an increased awareness of oral health, widespread use of fluoride toothpaste, improved tooth brushing habits, oral health awareness among parents and teachers, and improvement in infant feeding practices. The impact of these factors seems to be in lesser in underprivileged areas in some ethnic groups. Mother's low education level, her age, rural domicile of the mother, infrequent tooth cleaning, presence of plaque on the child's teeth, and frequent sugar consumption by the children have been associated with poor oral health of the children.[7],[8],[9]

Cost and consequences of oral problems

Oral disease is one of the most costly diet and lifestyle-related diseases. The cost of treating dental decay alone can easily exhaust a country's total health care budget for children. However, the cost of neglect is also high in terms of its financial, social, and personal impacts.[10]

In most developing countries, investment in oral health care is low. In these countries, resources are primarily allocated to emergency oral care and pain relief.[11]

Oral health on school education and learning

Early tooth loss caused by dental decay can result in failure to thrive, impaired speech development, absence from and inability to concentrate in school, and reduced self-esteem. Students with preventable or untreated health and development problems may have trouble in concentrating and learning, have frequent absences from school, or develop permanent disabilities that affect their ability to learn and grow.

Children with chronic dental pain are unable to focus, are easily distracted, and may have problems with schoolwork completion. They may also experience deterioration of school performance, which negatively impacts their self-esteem.[12]

Growth and development

The craniofacial complex allows us to speak, smile, smell, taste, chew and swallow, and cry out in pain. It provides protection against microbial infections and environmental threats. Oral diseases restrict activities in school, at work, and at home causing millions of school hours to be lost each year the world over. Moreover, the psychosocial impact of these diseases often significantly diminishes quality of life. The experience of pain, endurance of dental abscesses, problems with eating and chewing, embarrassment about the shape of teeth or about missing, and discolored or damaged teeth can adversely affect children's daily lives and well-being.[11]

Successful prevention through school-based efforts

Many oral health problems are preventable and their early-onset reversible. However, in several countries, a considerable number of children, their parents, and teachers have limited knowledge of the causes and prevention of oral disease. Thus, many oral conditions and diseases are preventable through screening as part of school-based programs.[10],[11] A school is a closed environment that concentrates a considerable number of individuals of the same age group who regularly attend the institution. For this reason, it has been considered ideal for developing health and oral hygiene programs with children in age groups that are favorable for adopting preventive measures.[13]

Lifestyle at school age

Schoolchildren's dietary behavior, as related to oral health and practices of oral health counseling, requires special attention. Despite a decreasing trend, schoolchildren's dental caries has not been eradicated. Dietary factors have been found to influence schoolchildren's oral health. There is convincing evidence for an association of the frequency and amount of sugar intake and dental caries. High consumption of sweets is also common among schoolchildren. The same tendency is observed in many developed countries although there are also large differences.[11]

Integration of oral health, general health, and school curriculum

Many risk behaviors stem from the school-age years. Schools have powerful influences on children's development and well-being. The need for the promotion of oral health in schools is evident, and it can easily be integrated into general health promotion, school curricula, and activities. Children can be provided with skills that enable them to make healthy decisions, to adopt a healthy lifestyle, and to deal with conflicts. Healthy behaviors and lifestyles developed at a young age are more sustainable. Messages can be reinforced throughout the school years.[10]

  Discussion Top

Oral disease among children can be eliminated. It is the responsibility of a dentist, a dental hygienist, and students to help and make oral health programs available. School-based oral health programs can be successful when education is combined with active prevention and/or treatment programs.

However, unfortunately, active preventive dentistry regimens, fluoride mouth rinses and tablet programs, sealant applications, remineralization therapy, and the use of fluoride-containing dentifrices while brushing can reduce decayed, missing, and filled surface in school children are not included by few schools around the world and none in India. This reduction can be accomplished with only a minimal change in self-behavior or compliance required of the student.

Leadership of dentists is essential to sustain the activities to effectively coordinate the functions of school health activities, nonformal educators, ICDS anganwadis, water and sanitation program, nutrition policy, health workers primary health care sector, food adulteration, popular mass media, and national cancer control program, and above all the communities, homes, and parents as also Panchayati Raj Institutions to achieve the desired goals.

  Conclusion Top

There is a pressing need for oral health to be promoted in schools worldwide. The potential for developing a comprehensive program using the health-promoting school approach is considerable. Commitment from central and local government, schools, families, and the community is critical. It is imperative for public health authorities and health professionals to provide sustainable support, in terms of technical assistance, funding, and/or learning materials to facilitate schools becoming health-promoting schools with oral health an integral part of it.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

The World Oral Health Report. Continuous Improvement of Oral Health in the 21st Century – The Approach of the WHO Global Oral Health Programme; 2003. Available from: http:/// [Last accessed on 2010 Jan 15].  Back to cited text no. 1
World Health Organization. Global Oral Health Data Bank. Geneva: WHO; 2001. Available from: [Last accessed on 2010 Jan 06].  Back to cited text no. 2
World Health Organization. Healthy Environment for Children. Initiating an Alliance for Action. Geneva: WHO; 2002. Available from: Last accessed on 2010 Jan 06].  Back to cited text no. 3
Meurman JH, Sanz M, Janket SJ. Oral health, atherosclerosis, and cardiovascular disease. Crit Rev Oral Biol Med 2004;15:403-13.  Back to cited text no. 4
Blumenshine SL, Vann WF Jr., Gizlice Z, Lee JY. Children's school performance: Impact of general and oral health. J Public Health Dent 2008;68:82-7.  Back to cited text no. 5
Who Information Series on School Health-Document Eleven. Oral Health Promotion: An Essential Element of a Health-Promoting School; 2003. Available from: [Last accessed on 2010 Jan 05].  Back to cited text no. 6
Petersen PE, Nyandindi U, Kikwilu E, Mabelya L, Lembariti BS, Poulsen VJ. Oral Health Status and Oral Health Behaviour of School Children, Teachers and Adults in Tanzania. Technical Report. Geneva: WHO; 2002.  Back to cited text no. 7
Szatko F, Wierzbicka M, Dybizbanska E, Struzycka I, Iwanicka-Frankowska E. Oral health of polish three-year-olds and mothers' oral health-related knowledge. Community Dent Health 2004;21:175-80.  Back to cited text no. 8
Sufia S, Khan AA, Chaudhry S. Maternal factors and child's dental health. J Oral Health Community Dent 2009;3:45-8.  Back to cited text no. 9
Kwan SY, Petersen PE, Pine CM, Borutta A. Health-promoting schools: An opportunity for oral health promotion. Bull World Health Organ 2005;83:677-85.  Back to cited text no. 10
Petersen PE. The World Oral Health Report 2003: Continuous improvement of oral health in the 21st century – The approach of the WHO global oral health programme. Community Dent Oral Epidemiol 2003;31 Suppl 1:3-23.  Back to cited text no. 11
Satcher D. Oral Health and Learning: When Children's Health Suffers, So Does Their Ability to Learn. 2nd ed. Satcher Health Leadership Institute; 2003.  Back to cited text no. 12
de Farias IA, de Araújo Souza GC, Ferreira MA. A health education program for Brazilian public schoolchildren: The effects on dental health practice and oral health awareness. J Public Health Dent 2009;69:225-30.  Back to cited text no. 13


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