Method: A controlled prospective trial aimed to evaluate the effectiveness of a school-based toothpaste programme to promote the use of fluoride toothpaste among primary school children residing in areas and attending schools in areas of high social deprivation in Dublin and Belfast. 100 children attending schools in Dublin and 100 children attending schools in Belfast were invited to take part. Baseline and 12 month follow-up assessments of [1] the children's COHRQoL using the Child Perception Questionnaire (8-10-years-old) and [2] the children's self-esteem using the Coopersmith Self-Esteem Inventory School-Form (CSEI-SF) were made. Analysis was conducted using AMOSv17 to test for direct and indirect effects with the aid of intensive resampling methods.
Results: 238 children completed the questionnaire at baseline and follow-up in Dublin (97) and Belfast (141). 45% were boys. 64% of the children were 8-years-old at follow-up. A partial latent hybrid model was fitted to examine the direct effect of the intervention on quality of life and self esteem. The model was also able to test the total effects on self esteem (both direct and indirect). All analyses were adjusted for baseline scores. Overall fit of the model was excellent: CFI = 0.972, RMSEA =0.054. The intervention had a direct significant effect on quality of life (P<0 .05) which in turn influenced self-esteem (P<0.001). There was no direct effect of the intervention upon on self esteem (P>0.10). However the total effect of the intervention on self esteem through indirect (via COHRQoL) and direct paths was found to approach significance (P =0.08).
Conclusions: This school-based toothbrushing intervention strongly influenced the children's quality of life which indirectly influenced their self-esteem.