Author, year, (country) | Study aims | Study setting and methods | Participants | Outcome | Limitations | Funding source | |
---|---|---|---|---|---|---|---|
Enablers | Barriers | ||||||
Dimitropoulos et al. (Australia) [30] | Possible challenges and barriers in continuation of school tooth brushing program | Primary schools; Focus groups | School staff and oral health aide | School staff level -Positive attitude, acceptability, and adaptability Organisational level -Local school staff and oral health aides infection control training, -Classroom-based toothbrushing activities, -Authoritative school staff, -Strong local school leadership, -Peer support -Flexibility of program implementation timings Children level -Program acceptability and children acceptance of lunchtime tooth brushing | Organisational level -Whole school toothbrushing activity School-level -In-cooperation of the program in school daily routine (initial concern) Children level -Older age children program acceptability issues, -Resistance of early morning toothbrushing -Mishandling of toothpaste | -One school did not consent for focus groups -Teacher’s response influenced by program supportive environment -Increased local community participation (community collaborative implementation approach) | Not given |
Yusuf et al. (England) [31] | Identifying barriers and enablers in fluoride varnish and toothbrushing programs implementation | Primary School; semi-structured interviews | Health champions (volunteers), general dental practitioners, and school staff | Children level -Children’s participation in toothbrushing activities (79.2%) Schools level -Adaptation of various parental consent approaches -Improve parents program engagement with the assistance of health champions (program Somali community volunteers’) -Program protocol development aimed at schools for facilitation of implementation -Program implementation flexible timelines -Adequate sharing of information among school staff -Program information translation in Arabic and Somali languages for parents School-level -Acceptability of health-promoting schools and by volunteers (Health Champions) and the dental team | School-level -Some schools struggle with the return of the consent forms from parents -Program communication issues with schools were highlighted by school staff -Inadequate transfer of information from head staff to the school staff School staff -Frustrated due to internal organizational factors, time, and space issues | -It was a pilot study and results cannot be generalised to a wider population | Not specified |
Glaser-Ammann et al. (Switzerland) [32] | Parents knowledge and attitude towards school dental health programs | Early childhood setting, questionnaire-based surveys | Parents-children’s dyads | Parents level -72% of parents accepted the importance of school dental programs in preschools -72% attended the prophylaxis programs -One fourth (25%) of the parents reported the dental health instructor as the best teacher for children toothbrushing learning skills -One fifth (20%) believe school dental instructor is also the right person to teach a healthy diet -Parents of children who were caries-free were more intended to participate in school dental programs (p = 0.11) -The statistically non-significant association was observed between parents' attendance in school dental health program and their educational level (p = 0.11), country of origin (p = 0.07), and their income (p = 0.07) Children level -60% believes that their child has benefitted from the program and now brush their teeth better -Just 36% reported that their child consumed healthy mid-morning snacks after the school dental health programs | Parents level -Parents assumed that the kindergarten teacher’s role in teaching toothbrushing skills is not important | -Study design limits the study statistical analysis to be considered explorative, and regression analysis and Bonferroni corrections were performed | Not given |
Woodall et al. (UK) [33] | Toothbrushing intervention effectiveness and process issues related to its coordination and delivery | Early childhood setting; case studies, interviews, surveys | Parents, children, school staff, oral health promotors | School staff level -Acceptability of the program School-level -Role of teaching support workers as the main contact point of program co-ordination with oral health promoters, -Linking toothbrushing intervention with school educational curriculum, -Training of school staff, -Provision of adequate information to parents along with children's weekly oral hygiene updates Parental level -Program acceptability and participation Children level -Engagement and acceptability of program, -Ripple effect | School staff level -Increased workload, -School committed staff frequent turnover, -Role of teacher’s as pseudo-parent Parents factor -Lack of engagement and participation, -Lack of awareness, Toothbrushes storage and hygiene issues (initial concern) | -Participants sample size issue in each of the data gathering approach -Survey didn’t include all schools -Sample size of case studies was not representative of the school population -Limited number of students participated in drawing activities due to lack of parental consent | Not given |
Natapav et al. (Israel) [34] | Factors associated with continuation of supervised toothbrushing program | Early childhood setting; telephonic surveys | School Teachers | School staff level -Teachers’ positive attitudes (70%) -Program acceptability (96%) --Willingness to teach toothbrushing skills (85%) and enjoying teaching toothbrushing skills (20%) -Correlation between Teachers' willingness for the continuation of the program with their belief in program success (r = 0.73), acceptance of their role of teaching toothbrushing skills to children (r = 0.53), and enjoying teaching toothbrushing (r = 0.59) -Statistically significant (p ≤ 0.05) association between teachers’ positive attitude towards the program sustainability and conduction of toothbrushing activities daily or several times a week Children level -84% of teachers reported that children like to learn toothbrushing skills | School staff level -Teachers anticipated more barriers were associated with their unwillingness for the program continuation (r =  − 0.34) -Thirty percent of teachers think its parent's role to train children in toothbrushing skills -Statistically significant (p ≤ 0.05) association was observed in teachers’ anticipated barriers of program sustainability and frequency of conduction of toothbrushing activities once a week or less | Not reported | Ministry of Health (MOH) |
Nyandindi et al. (Tanzania) [35] | Assessment of teachers'-led factors in the oral health educational programs activities | Primary schools, surveys and interviews, teachers’ oral examination and practical exercises | Teachers | Teacher’s level -85% of teachers acknowledge the importance of health sessions in enhancing their personal hygiene | Teacher’s factors -Teachers ranked health lessons in schools moderately important after reading, writing, and mathematics subjects -Twenty-four percent of teachers had taught about diet in the class, without mentioning the association between tooth decay and diet -Most of the teachers prefer to teach toothbrushing theoretically and perceive it a parent’s responsibility to teach their kids toothbrushing skills -Teachers claimed that the association between diet and tooth decay is not part of the health lesson curriculum of grade one class -Teachers complained of insufficient material and time to teach health lessons in the overly packed class of children (mean [SD]: 65 +/− 27 students) -Eleven percent of teachers perceived the need for further training in oral health education -Only 26% of teachers had skills of making wooden toothbrush Organisational level -School administration rarely inquired about the health lessons conducted in schools | Not given | Not given |