Promoting oral health of preschool children using non-dental personnel in rural Sri Lanka

Background: The limited availability of oral health care services and the lack of knowledge on oral health in the population have been documented as contributing factors for poor oral health among preschool children. Aims and Objectives: This study was designed to evaluate the effect of an oral health education intervention, in a Sri Lankan rural setting. The objective was to improve the oral health status among preschool children.  Materials and Methods: Mothers and their preschool children who were permanent residents of the area were considered eligible.  Two hundred and nineteen mother/child pairs were recruited using a convenience sampling technique. WHO criteria for detecting dental caries and treatment need were used along with modifications suggested by the National Institute for Dental Research. Loe’s plaque index was used on modified Ramfjord teeth to determine the oral hygiene status of preschool children. Mothers were educated on common oral health problems and causes among preschool children. Preventive strategies and available oral health care services were introduced. Their knowledge of healthy food habits, of oral hygiene practices and of opportunities for self-referrals to oral health care facilities was enhanced during the intervention. Pre- and Post-Intervention clinical assessments were performed on children. Data were collected at baseline and 6 months after the intervention. Results: The prevalence of caries was reduced from a mean DMFT of 3.60 to 3.00 (P<0.005) six months after the intervention. The major change was a reduction in the number of non-cavitated lesions, where the mean was lowered to 1.83 from 2.11 (P=0.04). Preschool children not in need of treatment for dental caries increased to more than half (69%) of the sample after 6 months, compared to 54% initially (p=0.564). The need for preventive care decreased from 41% to 19% (p<0.005).  The same observation was made for treatment need 5, where the reduction was from 14.6% to 5.9% (p=0.003). Prevalence of plaque was reduced from 86% to 81% post intervention. Conclusion: In conclusion, utilizing non-dental personnel to deliver appropriate education messages can improve the oral health of preschool children.