School Oral Health Program (SOHP) 1 Dr Hidayathulla Shaikh

Objectives At the end of the lecture, student should be able to – Enumerate aspects of SOHP. Mention objectives of SOHP. Enumerate ideal requirements of SOHP. Explain elements/components of SOHP.

Introduction School health is an important aspect of any community health program. It is an economical and powerful means of raising community health in future generations. William fisher, a dentist of England in 19 th century, was so concerned by the high caries level and lack of treatment in the child population. That he devoted much time in campaigning for compulsory inspection and treatment of children in schools.

Aspects of School Health Service 1) Health appraisal – “process of determining the total health status of the child”. 2) Health counseling. 3) Emergency care and first aid. 4) School health education. 5) Maintenance of school health records. 6) Curative services like check ups, treatment and referrals.

Objectives of SOHP a) To help every school child appreciate the importance of a healthy mouth. b) To help every school child appreciate the relationship of dental health to general health. c) To encourage dental health practices, personnel care, professional care, proper diet and oral habits. d) To enlist the aid of all groups and agencies interested in the promotion of school health.

e) To correlate dental health activities with the total school health program. f) To stimulate the development of resources to make dental care available to all children & youths. g) To stimulate dentists to perform adequate health services for children.

Ideal Requirements of SOHP 1) Should be administratively sound. 2) Should be available to all children. 3) Should provide the facts about dentistry and dental care. 4) Should aid in development of favorable attitude towards oral health.

5) Should provide environment to develop psychomotor skills necessary for tooth brushing and flossing. 6) Should include primary preventive programs. 7) Provide screening methods for early identification and referral of pathology.

Elements / Components of SOHP 1)Improving school – community relations. 2)Conducting oral inspections. 3)Conducting oral health education. 4)Performing specific preventive programs. 5)Referral for oral care. 6)Follow up.

1) Improving school – community relations The first step in organizing SOHP is formation of advisory committee. Which includes representatives from parents, teachers, school administrators, dental professionals and community leaders. The task of this committee is a)To highlight the oral needs of school children. b)To address schools concern in the promotion of oral health. c)To make people realize the importance of oral health.

2) Conducting oral inspections It builds a positive attitude in the child towards dentist and dental care. The child and parents are motivated to seek professional care. Base line and cumulative data for evaluation of SOHP are made available. Provides information as to the status of oral needs to plan a proper School Oral Health Program.

3) Conducting oral health education A SOHP should including teaching oral health in the classroom. Dentist should give each teacher sincere attention to developing proper attitude and importance of oral health in them. The training of teachers can be done to provide conducive oral environment between teachers, dentists and children. Information containing basic oral health concepts should be made available to the school.

4) Performing specific preventive programs 4a) Tooth brushing programs In a classroom 6-8 children can be taught as a group. Each one is given a cup, napkin, toothbrush and fluoride tooth paste. Then the children are demonstrated how to brush their teeth. The mastery of 45 0 angulation and short vibratory strokes can then be repeated on a dentoform model. Emphasis should be made that all teeth surfaces are covered and cleaned.

4b) Classroom based fluoride programs 4b i) fluoride mouth rinsing program It includes a kit which consist of fluoride rinse dispenser, cups, napkins and plastic disposal bags. From dispenser 2gm of sodium fluoride powder is collected and added to 1000ml of water. The rinse should be non sweetened and non flavored to discourage swallowing.

Rinsing programs are advised to the grades 1 to 12 but not to below grades. Five ml of the rinse is dispensed into each cup and distributed to all children and instructed to rinse it for 1 min, after which they are to spit carefully into the same cup. The napkin is used to wipe the mouth after which it is forced inside the cup to soak the fluid which are then disposed.

4b ii) Fluoride tablet program One tablet of 2.2mg sodium fluoride (contains 1mg fluoride) is given to each student. Then student chew and swishes the tablet for 1 min and swallows. This swish and swallow technique provides the benefit of topical as well as systemic benefit during tooth development and maturation.

4c) School water Fluoridation program The procedure makes the fluoride available to children for whom dental caries is a primary problem. The amount of fluoride added to school drinking water should be greater than community water supply that is 4-5 ppm. As children are present for a shorter period in the school and they consume less water during that time. Studies have shown a reduction in dental caries by about 40% among school children having school drinking water fluoridation.

4d) Nutrition as a part of Preventive Program School lunch programs are designed to provide child with nearly 1/3 rd of daily intake of nutrients. Efforts are made in reducing the frequency and intake of sugar products. The main objective of the program is a)To improve enrollment and attendance. b)To reduce school drop outs. c)To improve child health by improving nutrition level. d)To improve learning levels of children.

4e) Sealant placement program The placement of pit and fissure sealant is ideal for SOHP. Children from 1 st, 2 nd, 6 th and 7 th grades would be desirable for intervention of pit and fissure lesions. 1 st and 2 nd grade because first permanent molars will be sufficiently erupted while 6 th and 7 th second permanent molars will be sufficiently erupted for sealant placement.

5) Referral for oral care In few schools oral care is provided in the school itself but if the child requires further treatment referral is done. The program which has been proved effected is a “Blanket referral”. Here all children are given referral cards which are subsequently taken to the dentist. Dentist sign the cards upon completion of examination or treatment or both.

The sign cards are then returned to the school nurse or class teacher. Who plays an important role in following up the referrals with the child and parents.

6) Follow up The mere issuance of referral cards is of little value if steps are not taken to make it clear that school is interested in disease reduction. This needs a good follow up system and dental hygienist is a logical person to do such follow up examinations.