Objectives: In Andalusia, a southern region in Spain, all public health areas are progressively offering a program with tooth-brushing education (in the school), together with sealants, fluoride gel and limited operative dentistry (in the health center), to 7-14-yr children. The purpose is to analyze the effectiveness of this program on the tooth-brushing habit in 14-yr children. Methods: In East-Andalusia, in 1993, 277 14-yr children (test) corresponding to two health areas with the program were randomly selected. For each test area, an adjacent control area (without the program), was selected, giving a total of 353 children. This design allows a quasi-experimental comparison, since the reason for having or not the program in those years being political, and not related to oral or economic condition. Children were asked about their tooth-brushing habit. Results: There were no differences in sex or socioeconomic distribution between test and control children. The percent of children brushing their teeth at least 1/day were 88.4% (test) and 76.3% (controls) (p<0.001) (a 12.1% crude difference). The adjusted (by sex, socioeconomic level and health area) absolute difference was similar to that crude difference. Conclusion: A program containing health education in the school together with visits to the dentist in the health center is effective in the tooth-brushing habit of 14-yr children.
Supported by Fondo de Investigación Sanitaria (Spain) (Proyects #PI021129 and #PI051172).