238 - School-based, Teacher-led Oral Health Intervention, A Cluster Randomized Trial

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Methods:  We conducted a cluster-randomized pragmatic trial with 8-week follow-up among 1000 students. We randomly assigned 19 primary schools located within 9 villages in Koraro Millennium village cluster in Tigray Region, Ethiopia into three groups with equal probability (Group 1 – oral health education), Group 2 (oral health education and supervised tooth brushing) and control group. Stratified random sampling was employed; strata were defined by the distance to the town center, and availability of water in the schools. The primary outcome was the difference in mean gingival index scores between baseline and post evaluation. We conducted an intention-to-treat analysis with generalized estimating equation models.
Findings: Unadjusted analysis revealed that Group 2 (oral health education and supervised tooth brushing) experienced a statistically significant decrease in their mean gingival index scores showing an improvement in their gingival health compared to the control group. After adjusting for student-level and cluster level covariates the effect remained significant (Mean -0.19; 95% CI -0.29, -0.09; p-value: < 0.001) in Group 2 compared to the control arm. There was no statistically significant difference between Group 1 and control group.

Conclusion:  This study documents that simple, community-based interventions such as those for oral health that are delivered by non-dental personnel can improve gingival health, among elementary school children.


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This study was supported by a grant from GlaskoSmithKline (GSK). The funders of the study had no role  in study conception, design, data analysis and interpretation, or drafting of the manuscript. Dr Safaa Ahmed (the corresponding author) had full access to all the data in the study and had final responsibility for the decision to submit for publication.