Okul Öncesi Çocuklarına Verilen Ağız Diş Sağlığı Eğitiminin Etkinliği: Randomize Kontrollü Çalışma
Year 2025,
Volume: 9 Issue: 3, 284 - 292, 22.12.2025
Nesrin Arslan
,
Mihriban Gökcek Taraç
Abstract
Amaç: Ağız hijyeni konusunda erken eğitim, yaşam boyu sağlıklı alışkanlıkların oluşturulması için çok önemlidir. Bu çalışma, ebeveyn katılımlı eğlenceli bir ağız ve diş sağlığı eğitim programının 4-6 yaş arası çocuklarda plak indeksi, diş eti sağlığı ve ağız hijyeni bilgisi üzerindeki etkilerini incelemektedir.
Araçlar ve Yöntem: Dört anaokulunda 80 çocukla (40 deney, 40 kontrol) küme randomize kontrollü bir çalışma yürütülmüştür. Müdahale grubuna animasyon filmler, dental modeller ve interaktif aktiviteler kullanılarak ebeveyn katılımlı dört haftalık eğlenceli bir eğitim programı verilmiştir. Kontrol grubuna ise bir kerelik ağız sağlığı eğitimi verilmiştir. Veriler başlangıçta, bir haftada ve üç ayda toplanmıştır. Ağız hijyeni bilgisi, plak indeksi ve dişeti sağlığı standartlaştırılmış ölçekler kullanılarak değerlendirilmiştir.
Bulgular: Müdahale grubu, kontrol grubuna kıyasla anlamlı derecede daha yüksek oral hijyen bilgisi (F=26.767, p<0.001) ve daha düşük plak indeksi (F=6.774, p<0.001) ve dişeti problemi skorları (F=13.922, p<0.001) göstermiştir. Etki büyüklüğü analizi, bilgi (T2=4.41) üzerinde büyük bir etki ve plak indeksi (T2=1.53) ve dişeti sağlığı (T2=0.88) üzerinde büyük bir etki ortaya koymuştur.
Sonuç: Program, 4-6 yaş arası çocuklarda ağız hijyeni bilgisinde artışa, plak indekslerinde iyileşme ve diş eti sorunlarında azalma sağlamıştır. Bu durum, sağlık eğitiminde oyunlaştırmanın kullanılmasının küçük çocukların ilgisini çekmek ve sağlık sonuçlarını iyileştirmek için etkili bir yol olabileceğini göstermektedir.
Ethical Statement
Bu çalışma Karabük Üniversitesi Girişimsel Olmayan Araştırmalar Etik Kurulu tarafından 11.04.2022 tarih ve 821 sayılı kararla onaylanmıştır.
Thanks
Çalışmaya değerli katkılarından dolayı çocuklara, velilere, okul personeline ve öğretmenlere minnettarız.
Bu çalışma özeti, 06-07 Temmuz 2024 tarihlerinde Türkiye'de çevrimiçi düzenlenen 16. Uluslararası Tıp ve Sağlık Bilimleri Araştırmaları Kongresi'nde sözlü olarak sunulmuştur.
References
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1. Watt RG, Sheiham A. Integrating the common risk factor approach into a social determinants framework. Community Dent Oral Epidemiol. 2012;40(4):289-296.
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2. Van Meijeren-van Lunteren AW, You Y, Raat H, Wolvius EB, Kragt L. Caries preventive interventions and oral health inequalities: a scoping review. JDR Clin Transl Res. 2023;8(4):311-325.
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3. Jurgensen N, Petersen PE. Promoting oral health of children through schools-Results from a WHO global survey 2012. Community Dent Health. 2013;30(4): 204-218.
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4. Wigen TI, Wang NJ. Referral of young children to dental personnel by primary care nurses. Int J Dent Hyg. 2017;15(3):249-255.
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5. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380-387.
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6. Pitts NB, Zero DT, Marsh PD, et al. Dental caries. Nat Rev Dis Primers. 2017;3(1):1-16.
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7. Schuller AA, van Kempen IP, Poorterman JH, Verrips GEH. Een onderzoek naar mondgezondheid en preventief tandheelkundig gedrag van jeugdigen. Hoofdmeting 2011, een vervolg op de reeks TJZ-onderzoeken. Kies voor Tanden; 2013.
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8. Dogan D, Dulgergil CT, Mutluay AT, Yıldırım I, Hamidi MM, Colak H. Prevalence of caries among preschool-aged children in a central Anatolian population. J Nat Sci Biol Med. 2013;4(2):325-329.
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9. Taran PK, Mammadli N. Evaluation of parental guilt related to oral health problems in their children. Turkiye Klinikleri J Dental Sci. 2021;27(1):21-27.
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10. Langford R, Jago R, White J, et al. A physical activity, nutrition and oral health intervention in nursery settings: process evaluation of the NAP SACC UK feasibility cluster RCT. BMC Public Health. 2019;19(1):865.
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11. Aljafari A, ElKarmi R, Nasser O, Atef A, Hosey MT. A video-game-based oral health intervention in primary schools—a randomised controlled trial. J Dent. 2022;10(5):90.
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12. Winter J, Jablonski-Momeni A, Ladda A, Pieper K. Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status. Clin Oral Investig. 2018;22(6):2241-2249.
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13. Lee J, Lee T, Jung HI, Park W, Song JS. Effectiveness of an oral health education program using a smart toothbrush with quantitative light-induced fluorescence technology in children. Children. 2023;10(3):429.
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14. Eden E, Akyildiz M, Sonmez I. Comparison of two school-based oral health education programs in 9-year-old children. Int Q Community Health Educ. 2019;39(3):189-196.
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15. Angelopoulou MV, Kavvadia K, Taoufik K, Oulis CJ. Comparative clinical study testing the effectiveness of school based oral health education using experiential learning or traditional lecturing in 10 year-old children. BMC Oral Health. 2015;15:1-7.
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16. Cooper AM, O'Malley LA, Elison SN, et al. Primary school‐based behavioural interventions for preventing caries. Cochrane Database Syst Rev. 2013;2013(5):CD009378.
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17. Melo P, Fine C, Malone S, Frencken JE, Horn V. The effectiveness of the Brush Day and Night programme in improving children's toothbrushing knowledge and behaviour. Int Dent J. 2018;68(1):7-16.
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18. Sowmiya Sree RA, Louis CJ, Eagappan AS, Srinivasan D, Natarajan D, Dhanalakshmi V. Effectiveness of parental participation in a dental health program on the oral health status of 8-10-year-old school children. Int J Clin Pediatr Dent. 2022;15(4):417-421.
-
19. Akkaya DD, Sezici E. Teaching preschool children correct toothbrushing habits through playful learning interventions: A randomized controlled trial. J. Pediatr. Nurs. 2021;56:70-76.
-
20. Thwin KM, Zaitsu T, Ueno M, Kawaguchi Y. Effects of oral health education in Myanmar preschool children and guardians. J Investig Clin Dent. 2018;9(3):12346.
-
21. Shaheen R, AlShulayyil M, Baseer MA, Saeed Bahamid AA, AlSaffan AD, Al Herbisch R. Self-reported basic oral health knowledge of primary school students and teachers in rural areas of Saudi Arabia. Clin Cosmet Investig Dent. 2021;13:521-529.
-
22. Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smartphone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. 2021;21(1):18.
-
23. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-551.
-
24. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121-135.
-
25. Cohen J. A power primer. Psychol Bull. 1992;112(1):155-9.
-
26. Sawilowsky SS. New effect size rules of thumb. J. Mod. Appl. Stat. Methods. 2009;8(2):597-599.
-
27. Arora A, Khattri S, Ismail NM, Kumbargere Nagraj S, Prashanti E. School dental screening programmes for oral health. Cochrane Database Syst Rev. 2017;12(12):CD012595.
-
28. Zacharias S, Kahabuka FK, Mbawalla HS. Effectiveness of randomized controlled field trial instructing parents to supervise children on tooth brushing skills and oral hygiene. Open Dent J. 2019;13(1):76-84.
Effectiveness of Oral Dental Health Education for Preschool Children: A Randomized Controlled Trial
Year 2025,
Volume: 9 Issue: 3, 284 - 292, 22.12.2025
Nesrin Arslan
,
Mihriban Gökcek Taraç
Abstract
Purpose: Early education on oral hygiene is crucial for establishing lifelong healthy habits. This study examines the effects of a fun oral and dental health education programme with parent participation on plaque index, gingival health and oral hygiene knowledge in children aged 4-6 years.
Materials and Methods: A cluster randomised controlled trial was conducted with 80 children (40 experimental, 40 control) in four kindergartens. The intervention group received a four-week fun educational programme with parental involvement using animated films, dental models and interactive activities. The control group received a one-time oral health education session. Data were collected at baseline, one week and three months. Oral hygiene knowledge, plaque index and gingival health were assessed using standardised scales.
Results: The intervention group showed significantly higher oral hygiene knowledge (F=26.767, p<0.001) and lower plaque index (F=6.774, p<0.001) and gingival problem scores (F=13.922, p<0.001) compared to the control group. Effect size analysis revealed a large effect on knowledge (T2=4.41) and a large effect on plaque index (T2=1.53) and gingival health (T2=0.88).
Conclusion: The programme led to an increase in oral hygiene knowledge, improvement in plaque indices and reduction in gingival problems in children aged 4-6 years. This suggests that using gamification in health education can be an effective way to engage young children and improve health outcomes.
Ethical Statement
This study was approved by Karabük University Non-Interventional Research Ethics Committee (dated 11.04.2022 and numbered 821).
Thanks
We are grateful to the children, parents, school staff, and teachers for their valuable contributions to the study. The current study summary was presented orally at the 16th international medicine and health sciences researches congress held online in Turkey on 06 - 07 July 2024.
References
-
1. Watt RG, Sheiham A. Integrating the common risk factor approach into a social determinants framework. Community Dent Oral Epidemiol. 2012;40(4):289-296.
-
2. Van Meijeren-van Lunteren AW, You Y, Raat H, Wolvius EB, Kragt L. Caries preventive interventions and oral health inequalities: a scoping review. JDR Clin Transl Res. 2023;8(4):311-325.
-
3. Jurgensen N, Petersen PE. Promoting oral health of children through schools-Results from a WHO global survey 2012. Community Dent Health. 2013;30(4): 204-218.
-
4. Wigen TI, Wang NJ. Referral of young children to dental personnel by primary care nurses. Int J Dent Hyg. 2017;15(3):249-255.
-
5. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380-387.
-
6. Pitts NB, Zero DT, Marsh PD, et al. Dental caries. Nat Rev Dis Primers. 2017;3(1):1-16.
-
7. Schuller AA, van Kempen IP, Poorterman JH, Verrips GEH. Een onderzoek naar mondgezondheid en preventief tandheelkundig gedrag van jeugdigen. Hoofdmeting 2011, een vervolg op de reeks TJZ-onderzoeken. Kies voor Tanden; 2013.
-
8. Dogan D, Dulgergil CT, Mutluay AT, Yıldırım I, Hamidi MM, Colak H. Prevalence of caries among preschool-aged children in a central Anatolian population. J Nat Sci Biol Med. 2013;4(2):325-329.
-
9. Taran PK, Mammadli N. Evaluation of parental guilt related to oral health problems in their children. Turkiye Klinikleri J Dental Sci. 2021;27(1):21-27.
-
10. Langford R, Jago R, White J, et al. A physical activity, nutrition and oral health intervention in nursery settings: process evaluation of the NAP SACC UK feasibility cluster RCT. BMC Public Health. 2019;19(1):865.
-
11. Aljafari A, ElKarmi R, Nasser O, Atef A, Hosey MT. A video-game-based oral health intervention in primary schools—a randomised controlled trial. J Dent. 2022;10(5):90.
-
12. Winter J, Jablonski-Momeni A, Ladda A, Pieper K. Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status. Clin Oral Investig. 2018;22(6):2241-2249.
-
13. Lee J, Lee T, Jung HI, Park W, Song JS. Effectiveness of an oral health education program using a smart toothbrush with quantitative light-induced fluorescence technology in children. Children. 2023;10(3):429.
-
14. Eden E, Akyildiz M, Sonmez I. Comparison of two school-based oral health education programs in 9-year-old children. Int Q Community Health Educ. 2019;39(3):189-196.
-
15. Angelopoulou MV, Kavvadia K, Taoufik K, Oulis CJ. Comparative clinical study testing the effectiveness of school based oral health education using experiential learning or traditional lecturing in 10 year-old children. BMC Oral Health. 2015;15:1-7.
-
16. Cooper AM, O'Malley LA, Elison SN, et al. Primary school‐based behavioural interventions for preventing caries. Cochrane Database Syst Rev. 2013;2013(5):CD009378.
-
17. Melo P, Fine C, Malone S, Frencken JE, Horn V. The effectiveness of the Brush Day and Night programme in improving children's toothbrushing knowledge and behaviour. Int Dent J. 2018;68(1):7-16.
-
18. Sowmiya Sree RA, Louis CJ, Eagappan AS, Srinivasan D, Natarajan D, Dhanalakshmi V. Effectiveness of parental participation in a dental health program on the oral health status of 8-10-year-old school children. Int J Clin Pediatr Dent. 2022;15(4):417-421.
-
19. Akkaya DD, Sezici E. Teaching preschool children correct toothbrushing habits through playful learning interventions: A randomized controlled trial. J. Pediatr. Nurs. 2021;56:70-76.
-
20. Thwin KM, Zaitsu T, Ueno M, Kawaguchi Y. Effects of oral health education in Myanmar preschool children and guardians. J Investig Clin Dent. 2018;9(3):12346.
-
21. Shaheen R, AlShulayyil M, Baseer MA, Saeed Bahamid AA, AlSaffan AD, Al Herbisch R. Self-reported basic oral health knowledge of primary school students and teachers in rural areas of Saudi Arabia. Clin Cosmet Investig Dent. 2021;13:521-529.
-
22. Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran M, Mohebbi SZ. Development and evaluation of a gamified smartphone mobile health application for oral health promotion in early childhood: a randomized controlled trial. BMC Oral Health. 2021;21(1):18.
-
23. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-551.
-
24. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121-135.
-
25. Cohen J. A power primer. Psychol Bull. 1992;112(1):155-9.
-
26. Sawilowsky SS. New effect size rules of thumb. J. Mod. Appl. Stat. Methods. 2009;8(2):597-599.
-
27. Arora A, Khattri S, Ismail NM, Kumbargere Nagraj S, Prashanti E. School dental screening programmes for oral health. Cochrane Database Syst Rev. 2017;12(12):CD012595.
-
28. Zacharias S, Kahabuka FK, Mbawalla HS. Effectiveness of randomized controlled field trial instructing parents to supervise children on tooth brushing skills and oral hygiene. Open Dent J. 2019;13(1):76-84.