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Dental Tribune Middle East & Africa Edition | 6/2017 ◊Page 14 ORAL HEALTH 15 VARIABLES VISIBLE PLAQUE INDEX PRESENT TOOTH BRUSHING IN SCHOOL Before After N=1500 % N=1500 % 1,153 (76.8) 551 (36.7) ABSENT 347 (23.2) 949 (63.2) Table 1: Results of the examination in the number of dental surfaces free from plaque. *Chi-square test effective in imparting oral health knowledge and establishing good oral hygiene habits in school chil- dren and in improving their oral hy- giene status and the attitudes of their parents. With these positive fi nd- ings, it is recommended that similar programs be supported and imple- mented with a larger sample size to determine the long-term effect of such programs and to improve the poor oral health situation among school children.7 Furthermore po- lices for such preventive methods should be placed to emphasize the importance of its effect and govern their implementation. Acknowledgements The author would like to thank Dr. Hamda AlMesmar, Director of Dental Services Department, DHA for her kind support and guidance, Dr. Wedad AlMaydoor and Dr. Sara ALShaya from Ministry of Health and Prevention, UAE for facilitation of the program in the government schools. Dr. Nusaiba Shaker from the School Health and Education Insti- tutes unit for facilitation of private schools. Dental Services Department team of dentists (Dr. Dana Iran, Ini- tiative Leader of Oral Health Aware- ness) and the team of dental hygien- ists in dental services department, Dubai Health Authority for their dedication and hard work. Materials distributed to the students (toothbrushes, tooth paste and tooth brushing charts) were funded by Jordan® and Philips®. There was no involvement of Jordan® and Philips® in the methodology and implemen- tation of the study. We appreciate their support in the program. References 1. Shiamaa Shihab Al Mashhadani., et al. “National Survey of the Oral Health Status of School Children in Dubai, UAE”. EC Dental Science 8.2 (2017): 48-58. 2. Shiamaa Shihab Al Mashhadani. Tooth Brushing Schemes in Dubai Schools, A Step Forward in Oral Health Prevention. EC Dental Science 11.3 (2017): 88-94. 3. Macpherson L., et al. “National su- pervised toothbrushing program and dental decay in Scotland”. Jour- nal of Dental Research 92.2 (2013): 109-113. 4. http://www.child-smile.org.uk/ professionals/about-childsmile/ childsmile-core.aspx 5. Curnow M., et al. “A randomised controlled trial of the effi cacy of supervised toothbrushing in high- caries-risk children”. Caries Research 36.4 (2002): 294-300. 6. Jackson RJ., et al. “The effects of a supervised toothbrushing pro- gramme on the caries increment of primary school children, initially aged 5-6 years”. Caries Research 39.2 (2005): 108-115. 7. Satyawan G Damle., et al. “Effec- tiveness of supervised toothbrush- ing and oral health education in improving oral hygiene status and practices of urban and rural school children: A comparative study”. Jour- nal of International Society of Pre- ventive and Community Dentistry 4.3 (2014): 175-181. Interviews with the school nurses (oral health coordinators) involved a half hour interview with open-ended questionnaires related to: • Commitment and support of the school administration in allowing students to do the tooth brushing at the assigned time on a daily basis, • If the activity had fulfi lled the learn- ing objectives of the training, they had completed before the activity took place. Another question was about their professional opinion if this activity contributed to children’s acceptance for daily brushing and interest in oral health. • A set of questions were asked about the mechanism of the activity and the reactions of school staff in hav- ing students brush their teeth daily in the school. • Any barriers that effect implemen- tation of the tooth brushing activity. In regards to the commitment of schools, 71% of the oral health coor- dinators responded that if the school administration enforced the activity the compliance was high both from the teachers and students, others informed that allowing students to take a ten minute break to brush their teeth and return back to the class was considered as a disruption to the students daily schedule. A high response was to the questions about students’ reaction to brushing in school and how they considered it as an enjoyable task and made the students interested in brushing their teeth more often, even in schools that did not enforce daily tooth brushing students requested from their teachers to be given permission to brush their teeth. Many of the Oral health coordina- tors (55%) agreed that the main bar- rier to have brushing as a daily activ- ity in the schools was: • Storage facility of the toothbrushes in the classrooms and maintaining infection control standards. • Allowing students to leave the class to brush their teeth, • The cooperation of the class teach- ers and the head administration to continue with the tooth brushing activity for a long period. Parents Questionnaires Parents received a questionnaire to give feedback on their children ex- perience with the tooth-brushing scheme. The questions asked about: 1. Did you receive information on the tooth brushing challenge from the school? 2. Would you consider tooth brush- ing in school for your child as a good way for her/him to establish good oral hygiene habits? 3. Have you noticed any positive behavior change from your child to- wards tooth brushing at home? 4. How can the oral health team sup- port you to enhance and encourage your children to maintain their good oral health habits. Parents oral health lectures in school Continue tooth brushing for chil- dren in school Any other suggestions ………………. Parent’s feedback Response rates for the feedback questionnaire was 95%.There was a high response rate for the posi- tive behavior change towards tooth brushing (86%). Many parents an- swered that the idea of their children brushing daily in school would help to establish a good oral hygiene rou- tine (83%). They had increase interest to have more parents’ oral health sessions (72%). Most of the parents wanted their children to continue to brush at school (79%). There were 21% of parents who were concerned with infection control issues in re- gards to the storage of toothbrushes in schools. Conclusion The school-based oral disease pre- ventive intervention comprised of oral hygiene instructions and super- vised tooth brushing education was Outcome Data obtained from three resources, fi rst dental surfaces that were free from plaque, secondly the interview with oral health coordinators in the schools and fi nally the feedback questionnaires from the parents. Dental examinations for students involved in the brushing activity: A total number of 1500 students were involved in the tooth brushing activity, parents consents for oral ex- amination was obtained for the stu- dents aged 4-6 years only. Students were examined for plaque accumu- lation on teeth surfaces using The Visible Plaque Index (VPI). The index determines the frequency of tooth surfaces covered with clearly visible plaque,7 the outcome of which was dichotomized as “present” (at least one surface covered with visible den- tal plaque on the buccal region of the maxillary anterior teeth) or “ab- sent” (dental plaque not visible on any surface of the buccal region of the maxillary anterior teeth). Scores were recorded on a screening sheet. The examination was done twice for the same students one before the tooth brushing activity started and the next one was after 90 days of continuous brushing in schools. Associations between self-reported tooth brushing frequency and The Visible Plaque Index (VPI) was as- sessed using the chi-square test. Statistical analyses was performed with the aid of the SPSS Statistics™ program (SPSS for Windows, version 20.0, SPSS Inc., Chicago, IL, USA). Interview with school nurses (oral health coordinators) The The three-in-one three-in-one composite composite composite solution solution solution Charisma® Topaz Innovative chemistry for day-to-day natural restorations. Giving a hand to oral health.