Evaluation of an outreach school dental service in rural China

Abstract

OBJECTIVE: To establish a demonstration school-based oral health care service in a rural area in China and to investigate its effects on school children's oral health. METHODS: Study population was children attending grade 3 in seven primary schools in a rural township in southern China in 2003. Clinical examinations and a questionnaire survey were conducted. By random selection, an outreach dental service was offered free of charge to the children in four schools. Preventive and restorative dental services were provided annually by local dentists according to the children's individual needs. Cost of the materials used and time taken to deliver the service was recorded. Evaluation of outcome was carried out after 3 years by conducting clinical examinations. RESULTS: A total of 1635 children were examined at baseline, 1096 in the test group and 539 in the control. Their mean age was 9.7 years and 55% were boys. At baseline, over 90% of the children had dental caries, mainly in primary teeth, and similar in both the test and control groups (p>0.05). After 36 months, 1493 (92%) children were examined, 1001 and 492 in the test and control groups respectively. Prevalence of dental caries in permanent teeth in the test and control children were 11% and 25% respectively (p<0.001). The mean DT score of the test children was lower (0.2 vs. 0.4, p<0.01) while of the mean DMFT scores of the two groups were similar (0.6 vs. 0.5, p>0.05). Moreover, a lower percentage of the test children had dental calculus (55% vs. 63%, p=0.004). The resources spent on providing the service per child per year was 22.7 man-minutes for staff and less than US$1 for materials. CONCLUSION: The study outreach school dental service was effective in improving the oral health of the children and was generally affordable by the local community.