Peer-reviewed article
Integration of oral health promotion in primary school health programs: A scoping review.
Surani N, Fernandes Fagundes NC, Kaur H, Gokiert R, Perez-Garcia A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined how oral health promotion is integrated into primary school health programs by analyzing 31 published studies. Most studies were from high-income countries and used classroom education, structured toothbrushing, and teacher involvement to teach children about oral health, focusing on diet and hygiene. The review found that few studies included parents or educators as active participants, and most measured only child-level outcomes rather than broader program effects. The authors call for more comprehensive, theory-based approaches that engage multiple stakeholders to make oral health programs sustainable.
Key points
- Over 70% of studies were concentrated in high-income and upper-middle income regions
- Teachers were the most common intervention delivery agents, identified in 25 of 31 studies
- Only 12 studies included parents or guardians, mostly as passive recipients
- Unhealthy diet (18 studies) and poor hygiene (11 studies) were the most frequently targeted risk factors; tobacco use, stress, and injury were largely overlooked
- None of the 31 studies applied integration-specific or implementation science frameworks or models
Limitations
The review does not report effectiveness of interventions or comparative outcomes between different approaches. The geographic concentration in high-income countries limits understanding of oral health integration in low- and middle-income settings where child oral health burden may be highest.
Abstract
Children experience significant oral health problems, compromising learning and quality of life. Schools are effective in promoting children's overall health, within which oral health can be integrated. This scoping review aimed to map integration of oral health within primary school health programs. The review was guided by Arksey and O'Malley's framework and adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses extensions for Scoping Reviews (PRISMA-ScR). JBI Manual for Evidence Synthesis was referred to for data extraction. A systematic search was performed across six databases with no restrictions on dates and locations. The review included 31 articles published between 1981 and 2025. Over 70% studies were concentrated exclusively in high-income and upper-middle income regions. Quantitative methods were reported in twenty-one studies. All studies reported programs targeting children. Only 12 included parents or guardians, mostly as passive recipients. Most common intervention delivery agents were teachers, identified in 25 studies. Unhealthy diet and poor hygiene were frequently targeted common risk factors, identified in 18 and 11 studies respectively. Tobacco use, stress, and injury were largely overlooked. Twenty-seven studies reported activity-based learning to promote general health. Classroom education, followed by interest holder engagement and structured toothbrushing were used to promote oral health, focusing on student skill-building and empowerment, alongside teacher involvement. None of the studies applied integration-specific or implementation science frameworks or models. Twenty-six studies assessed child-level oral health outcomes. In contrast, only seven reported changes in knowledge, attitudes, and practices among educators and parents. Ten reported program-related outcomes. Structured programs engaging children, targeting risk factors related to hygiene and diet alongside interest holder engagement and curriculum integration hold promise. This review highlights the need for theoretically informed, comprehensive, policy-focused, multi-level, multi-risk factor approaches to support sustainable integration of oral health into school health programs.