Oral diseases, especially tooth decay, affect children worldwide. Poor oral health can have an impact on children’s well-being. Treating oral health can be expensive, and it can come at a cost to both families and the community. School dental screening involves a dental professional examining children’s mouths and teeth at school. The dental professional will then let parents or caregivers know about their child’s oral condition and treatment needs. It aims to identify oral health concerns at an early stage. A further aim is to prompt parents or caregivers to seek treatment for the child.
What was the research?
A systematic review to find out if school dental screening improves the oral health of children. If it does, which screening method works best? This is the second update of a review that was published in December 2017 and first updated in August 2019.
Who conducted the research?
The research was conducted by a team led by Ankita Arora of the International Medical University, Kuala Lumpur, Malaysia, on behalf of Cochrane Oral Health. Sumanth Kumbargere Nagraj, Shivi Khattri, Noorliza Mastura Ismail and Prashanti Eachempati were also on the team.
What evidence was included in the review?
Our updated search identified one new study to be included since the last version of the review was published. In total, the review includes eight randomised controlled trials that presented results for 21,290 children. Four studies took place in the UK, two in India, one in the USA and one in Saudi Arabia. The children were 4 to 15 years old. Studies looked at the oral health and dental attendance of children who were screened in school compared to children who did not have screening. Some studies also compared different ways of screening and different forms of follow‐up (e.g. advice letter or referral).
What did the evidence say?
We do not know whether traditional school dental screening improves dental attendance. Studies looking at screening based on specific criteria (e.g. targeted at children not registered with a dentist) suggested it may be slightly more effective than no screening for improving attendance at the dentist. There may be no difference between criteria‐based screening and universal screening for improving dental attendance, but we are very unsure about the results.
A personalised or specific referral letter to parents may improve dental attendance more than a non‐specific letter, but we are very unsure about the results.
Screening with added motivation (health education and offer of free treatment) may improve dental attendance compared to screening alone, but we are very unsure about the results.
One study comparing different referral letters (with more or less information about dental diseases) found that neither was better than the other for improving dental treatment in children.
A specific referral letter did not encourage more parents to take their children to the dentist when compared to a letter with generic advice to visit the dentist.
The eight studies followed up children for 3 to 11 months after they received screening. Therefore, we do not know the effects of screening over a longer period of time.
How good was the evidence?
We are uncertain whether traditional school dental screening improves dental attendance as we assessed the certainty of the evidence as low or very low.
What are the implications for dentists and the general public?
In this systematic review, we found low or very low certainty evidence, which is insufficient to draw conclusions about the role of school dental screening for improvement in dental attendance. There is an absence of evidence to comment on the efficacy of school dental screening to improve oral health.
What should researchers look at in the future?
All of the trials except one measured only dental attendance as the primary outcome. Even though dental attendance post-screening is a desirable outcome, it does not guarantee further follow-up to completion of treatment and is not a measure of improved oral health.
We recommend standardisation of definitions of school dental screening programmes so that future research can be based on it. We encountered different terminology for various screening and referral procedures, for example, ‘criteria-based’ screening, and screening with ‘specific’ referral letters. We cannot comment on the universal application of these terms and it makes drawing comparisons difficult. We also recommend standardising various forms of screening processes.
More clinical trials on this topic are needed. We recommend the conduct and reporting of clinical trials be improved by following the CONSORT group guidelines.
Link
Arora A, Kumbargere Nagraj S, Khattri S, Ismail NM, Eachempati P. School dental screening programmes for oral health. Cochrane Database of Systematic Reviews 2022, Issue 7. Art. No.: CD012595. DOI: 10.1002/14651858.CD012595.pub4
This post is an extended version of the review’s plain language summary, compiled by Anne Littlewood at the Cochrane Oral Health Editorial Base. It was originally published on 1st May 2018, updated on 8 August 2019 and again on 28 July 2022.
Cochrane Oral Health 
We all know what a public healthcare issue this is and how important preventive dental education is for our children. The American Dental Association needs to allow the dental hygienist profession to intervene as public healthcare officials to educate our preschool and elementary children across our nation.
Pingback: School dental screening - National Elf Service