Oral health status of schoolchildren living in remote rural Andean communities: A cross-sectional study

Abstract

A BSTRACT Objective: Oral health promotion (OHP) was introduced in Peruvian primary schools in 2013, and no evaluation has been undertaken in rural areas since then. To measure OHP outcomes, this cross-sectional study aimed to assess the oral health (OH) status of schoolchildren living in a remote rural area of the Cusco region. Materials and methods: Sixty-six children were recruited in three remote rural communities and in a rural district capital. Six dimensions of OH (knowledge, attitudes, behaviors, dental plaque, dental caries, and quality of life related to OH) were measured using self-administered questionnaires and dental examinations. Wilcoxon–Mann–Whitney tests were conducted to compare outcomes between two types of settings (remote rural community and district capital). Multiple linear regression models were fit to identify which variables can explain the variance observed in the decayed, missing, and filled teeth (DMFT) index. Results: The median percentage of dental plaque in remote rural communities was 78.7+ (interquartile range [IQR] 71.5–82.8) and 78.6+ (IQR 72.7–82.2) in the district capital ( P = 0.90). The prevalence of dental caries was estimated to be 94.1+ (95+ confidence interval [CI] 71.1–>99.9) in the district capital and 98.0+ (95+ CI 88.3–>99.9) in remote rural communities ( P = 0.43). Conclusion: These results suggested that OHP interventions had not reached their full potential. Identifying different factors that influence the reported outcomes would provide a more comprehensive understanding and help to tailor OHP interventions.

Intersectoral oral health promotion interventions for schoolchildren living in remote rural Andean communities: a realist evaluation

“…As will be described, two external and two internal CM exerted a negative influence, while only two internal CM exerted a positive influence on OHP outcomes. IOHP intervention effects related to CM configurations are not presented in this manuscript; these positive and negative outcomes on schoolchildren are being published in another article (31).…”

“…In the first phase, potential contextual elements and underlying mechanisms that might influence the implementation of intersectoral health promotion interventions in schools were mapped (29) and an initial program theory of the Peruvian IOHP interventions in rural communities was developed (30). In the second phase, IOHP outcomes were documented in schoolchildren, using quantitative measures including dental examinations and validated questionnaires (31). In the subsequent phase, focus groups and semi-structured interviews with various stakeholders involved in IOHP were conducted; they were presented with measured outcomes, and by inference explored contextual elements and mechanisms (28) to identify which mechanisms were triggered in the given predetermined contexts.…”

“…Stakeholders were recruited according to theoretical sampling (33), so that all types of stakeholders involved in IOHP would be represented: 1) OH professionals, 2) teachers, 3) parents, 4) education managers, 5) health managers, and 6) other community stakeholders. Teachers, parents, and other community stakeholders were recruited in three remote rural communities where the second phase of this project was conducted (31). OH professionals were recruited in the health center that provides coverage to the participating remote rural communities.…”

Importance of oral health education for parents and educators in children's oral health: A literature review

“…Importance of oral health education for parents and educators in children's oral health: A literature review to products (BERGERON et al, 2020;SWE et al, 2021). In addition, a higher incidence of tooth decay and lower adherence to and frequency of brushing were found in 3-year-olds living in rural areas compared to those living in urban areas ( VAN CHUYEN et al, 2021).…”