Oral Health Status and Oral Health Behaviour among 5- to 6-year-old Palestinian Schoolchildren – Towards Engagement of Parents and Schoolteachers for Oral Health through Schools

Purpose: 1. To assess the oral health status and health behaviour of 5- to 6-year-oldchildren and the influence of socio-behavioural factors on oral health among children, and 2. evaluate dental knowledge and attitudes related to oral health promotion of children among mothers and schoolteachers in Palestine.
Materials and Methods: This cross-sectional survey was carried out in 2017, and recruited samples of children (n = 3939, 53.8% boys, 44.8% girls) from 61 primary schools, their mothers and schoolteachers (n = 53). Participants were selected randomly by multistage stratified cluster sampling. Calibrated dentists performed oral examinations of 5- to 6-year-old schoolchildren based on WHO criteria. Mothers and teachers completed WHO self-administrated questionnaires to assess children’s oral health behaviour, as well as their knowledge and attitudes towards children’s dental care.
Results: Caries prevalence of primary teeth was 83.4% and caries experience was high (dmf-s = 11.17). One-fourth of children suffered from pain or discomfort from teeth, and 57.7% of children had seen a dentist within the past 12 months, frequently due to pain or problems. Consumption of sugars was frequent and only 19.7% brushed their teeth every day. Neglect of dental visits, infrequent toothbrushing, being a child from families of urban settings and high socioeconomic status were greatly affected by caries. Mothers and schoolteachers had mostly positive attitudes towards school-based oral health care. However, the availability of dental health education materials was extremely low.
Conclusion: The establishment of school-based oral health programmes, including effective use of toothpaste containing fluoride for caries prevention, is greatly needed to improve the oral health of Palestinian children. The introduction of fluoridated school milk is highly recommended. The establishement of school programmes should encompass active involvement of schoolteachers and mothers to promote the development of healthy lifestyles and sustainable oral health behaviours among schoolchildren. Provision of materials for health education by schoolteachers and mothers is urgently needed.