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A School Based Oral Health Programme

A School based Oral Health Programme in Kuwait during 1986-1997

       
Introduction

In 1986 an oral health programme for the schoolchildren in the Al-Ahmadi governorate was initiated as a joint venture between the Ministry of Health, Kuwait and the Royal Dental College, Copenhagen, Denmark. This presentation is based on the study by Vigild and co-workers published in 1999.


       
Background and Rationale

Until 1986 the only form of dental care in the Al-Ahmadi governorate in the south of the capital of Kuwait were 20% of the country's population lived, was emergency treatment in public dental clinics. No oral health preventive programmes existed in schools. Base-line study at the beginning of the programme showed already that the oral health of children in Ahmadi had worsened as seen among the 6-year olds where the caries free children decreased from 19% in 1982 to 9% in 1986.


       
Programme Outline

The programme was implemented during the 1986-87 school year for the children in the first and second classes of the primary schools in the Ahmadi governate. Eventually the programme included all primary schoolchildren (age 6-10 ) in the public schools (classes 1-4) in Ahmadi. In 1996-97, altogether a total of 17,799 children were in the programme.

  • The children received bi-weekly supervised tooth brushing with fluoridated toothpaste and fluoride rinsing with 0.2% NaF solution.
  • Fissure sealing carried out on newly erupted permanent molars from 1993.
  • Restorative treatment of dental caries performed for the needy children.
  • Oral health education conducted with the co-operation of the teachers.
  • Oral health education of mothers and teachers at regularly held meetings.

Children were examined clinically each year before the start of the treatment. Dental caries was scored at surface level (DMFS) according to the WHO criteria. Twenty-eight trained and calibrated dentists carried out examinations.


The mean number of decayed permanent tooth surfaces (DS) by class from 1986 to 1997
1986-87 1987-88 1988-89 1989-90 1990-92 1992-93 1993-94 1994-95 1995-96 1996-97
1. Class 0.5 0.4 0.3 0.2 - 0.3 0.2 0.2 0.2 0.1
2. Class 1.0 0.3 0.4 0.2 - 0.7 0.6 0.4 0.4 0.3
3. Class
0.7 0.5 0.4 - 1.3 1.1 0.7 0.7 0.6
4. Class

0.8 0.4 - 1.4 1.4 0.9 0.8 0.7











 

The DMFS increment by class from 1986-87 to 1996-97
1986-87 to 1987-88 1987-88 to 1988-89 1988-89 to 1989-90 1992-93 to 1993-94 1993-94 to 1994-95 1994-95 to 1995-96 1995-96 to 1996-97
Class level 1st to 2nd 0.3 0.4 0.2 0.6 0.4 0.4 0.3
2st to 3nd 0.6 0.3 0.3 1.0 0.4 0.6 0.5
3st to 4nd
0.6 0.4 0.8 0.5 0.6 0.4


       
Achievements

From the beginning the community responded to the programme in a positive manner. Clinics were installed in the schools with support from the principals and teachers and children were treated during school hours.

  • An average of 94% of the children participated in the curative and preventive programme through all the years evaluated.
  • DMFS decreased from 1986 to 1990, increased during the war (1990-92) and decreased again during 1993-97
  • In 1987, for example, 64% of the children in class 2 were caries free and it increased to 78% to 1990, dropped to 71% in but increased again from 1993 to 1997 with 79% of the children in class 2 being caries free.
       
Constraints to the progress of the project

The programme was discontinued in August 1990 due to the Iraqi occupation of Kuwait when all the dental clinics were demolished. In September 1992 the programme was fully re-established after the dental clinics were reconstructed and new dental personnel employed and trained.


       
Conclusion

The national oral health survey of Kuwait in 1993 in all all 5 governates showed that dental health among the children in Al-Ahmadi was better than from the other parts of Kuwait, as opposed to the finding in 1982, where the children in this area did not differ from children in the other parts of the country. It may be concluded that the oral health of the children improved due to the programme.


       
References

Vigild M, Skougaard M, Rabab H and Halling C. An oral health programme for schoolchildren in Kuwait 1986-97. Community Dent Health, 1999; 16: 102-106.


Last updated by Gisela Ladda Tayanin