Journal of Indian Society of Pedodontics and Preventive Dentistry
Journal of Indian Society of Pedodontics and Preventive Dentistry
                                                   Official journal of the Indian Society of Pedodontics and Preventive Dentistry                           
Year : 2005  |  Volume : 23  |  Issue : 3  |  Page : 131--133

Evaluating the effectiveness of school-based dental health education program among children of different socioeconomic groups

Pankaj Goel, M Sehgal, R Mittal 
 Department of Community Dentistry, Maulana Azad Dental college & and Hospital, New Delhi, India

Correspondence Address:
Pankaj Goel
Room No. 413, IVth Floor, Taneja Block, Maulana Azad Dental College and Hospital, I. P. Head Post Office, New Delhi - 110 002


The aim of the present study was to evaluate the effectiveness of Dental Health Education programs among school children of different socioeconomic groups. The investigators made a visit to three different schools and studied 500 children. A ten items, open-ended, self-administered questionnaire was pretested on the primary and higher primary school children before and after an educational intervention. A second visit was made to one of the schools 1 year later and the same questionnaire was re-administered to those subjects who had participated in the original study. Results showed that although educational intervention was successful in improving the Dental health awareness of most children, the socioeconomic background is an important determinant for the same. Also, single-lecture technique seems to be inadequate in improving the knowledge of children in the long term.

How to cite this article:
Goel P, Sehgal M, Mittal R. Evaluating the effectiveness of school-based dental health education program among children of different socioeconomic groups.J Indian Soc Pedod Prev Dent 2005;23:131-133

How to cite this URL:
Goel P, Sehgal M, Mittal R. Evaluating the effectiveness of school-based dental health education program among children of different socioeconomic groups. J Indian Soc Pedod Prev Dent [serial online] 2005 [cited 2022 Aug 8 ];23:131-133
Available from:

Full Text

School children are considered to be an important target group for various health education activities with the underlying objective of inculcating healthy lifestyle practices to last for a lifetime. Review of literature shows that the effectiveness of educational interventions among schoolchildren is dependent on environmental factors such as source of information, dental experience, residence status, etc. [3],[4] Because these factors are in turn, dependent on the socioeconomic status of the parents of these children, it is important to study the influence of socioeconomic background on the awareness levels of children. There is a paucity of data about the effectiveness of educational intervention among school children in the Indian context and therefore, the aim of the present study was to assess the relative improvement in the knowledge achieved after imparting Dental Health Education to school children of various socioeconomic groups. In addition, the study evaluates the long-term effectiveness of conventional (one-time) lecture technique. An understanding of the different information needs of different children can be useful in suitably restructuring school health programs.

 Materials and Methods

The age group selected in the present study was 10-13 years. Schools were selected on the criteria of proximity (urban location) and co-education (male and female representation). Because most children were not able to disclose their fathers' occupation and income reliably, the type of school (i.e., Government aided, or Private) was used as a proxy indicator of the child's socioeconomic background (in ascending order). Three schools (one of each type) comprising of approximately 500 subjects were included in the study.

A 20 min single lecture schedule was prepared on a range of topics, that is, brief introduction to dental anatomy, common oral diseases, oral hygiene instructions, dietary instructions, and importance of regular visits to the dentist. The local language (i.e., Hindi) was used for the presentation because it was frequently spoken at home and understood by most children. Also several visual aids (e.g., charts and models) were prepared and demonstrated during the presentation to keep the children interested. The investigators rehearsed the presentations before visiting each school.

Prior appointments for the presentation were obtained from the school authorities. Students were allocated into groups (usually classwise), not exceeding 40 - 50 children in a group. A ten items, open-ended, self-administered questionnaire was pretested to all students before and immediately after the presentation. [Table 1] illustrates the questionnaire.

A revisit was made 1 year later to one of the same schools (i.e. aided school) and the questionnaire was re-administered to those children who had participated in the educational intervention earlier. The resulting data was coded, cleaned and analyzed to assess inter-group differences.


The pre verses postintervention results obtained from the questionnaire are tabulated in [Table 2]. The general trend of improvement in knowledge was evident across all socioeconomic groups. Children of Government schools had a poor awareness of Dental health in general (except for the VIth-grade students) as compared to children of private/aided schools. Also, the older subjects (i.e., higher primary class group) were more aware of dental health as compared to their younger counterparts (primary class group).

[Table 3] tabulates the awareness levels of the subjects 1 year after the educational intervention. Seemingly, there is a reversal of awareness levels among the subjects within 1 year in the absence of any reinforcement on Dental Health Education for them.


The Dental Health Education program was effective in improving the knowledge levels of most children. This is in accordance with the findings of Rubinson and Tappe,[5] Otchere et al.,[6] Rayner,[7] Hartono et al.,[8] and Worthington and Fiona.[9]

In general, the children studying in Government schools had lower awareness levels than those in private/aided schools in both pre and postintervention assessment. This difference can be attributed to the lower socioeconomic background of the children of Government, schools as identified by Wright,[3] Chen,[4] and Hamilton and Coulby.[10] Similarly, age-group comparisons show that, in general, the children studying in primary classes had lower awareness levels than those in higher primary classes in both pre and postintervention assessment. This difference is probably due to the lower comprehension levels of the younger children.

Single-lecture technique appears to be inadequate because after 1 year the difference in the proportion of correct responses to the questionnaire reverted back to preintervention levels. This is reflective of the importance of reinforcing knowledge in health education endeavors.

The following were the limitations of the present study:

1. The limited sample size used in this study makes inter-group differences debatable. Hence, more extensive studies need to be conducted to document such differences reliably.

2. Although all possible efforts were made to standardize the presentations, it is possible that other environmental factors such as barriers of communication, efficiency of educators, etc., could have had a modifying effect on the effectiveness of the educational intervention.

Hence, within the limitations of this study, the following recommendations are made for restructuring school based Dental Health Education programs:

1. Government schools as compared to private/aided schools, and primary classes as compared to higher classes should be targeted more often for Dental Health Education.

2. Reinforcement of knowledge is absolutely necessary. Incorporating chapters on Dental health in school textbooks is one way to do this. Similarly, Teachers' Training Programs can ensure continuity of reinforcement.

3. Socioeconomic status of the parents is an important determinant of Dental health awareness among their children, and therefore the parents of children (especially those belonging to the lower social status) must be included in health education endeavors. Parent-Teacher Association Meeting is one forum that can be optimally exploited by the Dental team for the overall benefit of children in the long term.

4. In addition to the lecture technique, hands-on training in the form of brushing, flossing and mouth-rinsing drills should be organized in schools to serve as motivational tools for the children.

5. The Dental team, to provide a healthful school environment in the Dental context, should advocate limiting the availability of cariogenic foodstuffs in school canteens.


1Horowitz AM. Effective oral health education and promotion programmes to prevent dental caries. Int Dent J 1983;33:171-181.
2Kawaguchi Y, Sasaki Y, Yonemitsu M, Okada S. Community oral health promotion activities in Japan. J Dent Res 1994;73:194.
3Wright FA. Children's perception of vulnerability to illness and dental disease. Community Dent Oral Epidemiol 1982;10:29-32.
4Chen MS. Children's preventive dental behaviour in relation their mothers' socioeconomic status, health beliefs and dental behaviors. J Dent Child 1986;53:105-9.
5Rubinson L, Tappe M. An evaluation of a pre school dental health programme. ASDC J Dent child 1987;54:18692.
6Otchere DF, Leake JL, Lee AJ. Evaluation of the effectiveness of the Toronto Dental Education Programme. J Dent Res 1988;67:192.
7Rayner JA. A dental health education programme for nursery school children. J Dent Res 1989;68:940.
8Hartono SW, Herawati T, Van Palenstein HWH. Implementation of a community oral health programme in Cimareme, Bandung. J Dent Res 1997;76:90.
9Worthington HV, Fiona AH. A Cluster Randomized Controlled Trial of a Dental Health Education Program for 10-year-old children. J Public Health Dent 2001;61:227.
10Hamilton ME, Coulby WM. Oral health knowledge and habits of senior elementary school students. J Public Health Dent 1991;51:212-9.