Effectiveness of an oral health education and promotion program in kindergartens in China

Objective: To evaluate the effect of a 2-year oral health education and promotion program implemented in kindergartens in China. Methods: 731 3-year-old children were recruited from 10 kindergartens in Miyun county, Beijing, China. The kindergartens were randomly assigned into two groups based on the children's baseline mean dmfs scores. Oral health education was provided to teachers in the test kindergartens every 3 months. The Crest oral health education materials and program was used. Oral health education sessions for the test children and their parents were conducted monthly. Children in the test kindergarten brushed their teeth twice daily with fluoride toothpaste (1100 ppm F-) in their kindergarten under the supervision of teachers during weekdays. No oral health education session and no supervision tooth brushing activities were carried out in the comparison kindergartens. A clinical examination of the study children and a questionnaire survey of their parents were conducted 3 months after the program terminated. Results: 514 children remained in the study after 2 years. The mean caries increment was 2.47 dmfs for the test group (n=258) and 3.56 dmfs for the comparison group (n=256). The reduction in dmfs was 30.6% (p=0.009). At the evaluation, a significantly higher percentage of children in the test group than in the comparison group reported brushing their teeth twice a day (87.6% vs.69.0%, p<0.001). Parents of children in the test group had better dental knowledge and attitude than that of parents of children in the comparison group. Conclusion: The Crest kindergarten-based oral health education and promotion program is effective in establishing good oral health habits among preschool children and in increasing dental awareness of their parents, and in conjunction with supervised daily tooth brushing with fluoride toothpaste can reduce caries in preschool children in China. Supported by the Procter & Gamble Company.