Ankita Arora, Sumanth Kumbargere Nagraj, Shivi Khattri, Noorliza Mastura Ismail, Prashanti Eachempati
What was the aim of this review?
Oral health means the condition of the mouth, throat, teeth and gums. The aim of this Cochrane Review was to find out if school dental screening improves oral health of children; and if it does, which screening method works best. We found eight relevant studies to answer this question. This is the second update of a review that was published in December 2017 and first updated in August 2019.
There is not enough evidence to draw conclusions about whether traditional school dental screening can improve dental attendance (can lead to children visiting the dentist more often). Moreover, it is not clear if improvement in dental attendance leads to better oral health. We still need high‐quality studies that measure the impact of screening on oral health over longer periods of time.
What did this review study?
Oral diseases, especially tooth decay (called 'dental caries' by dentists), affect children worldwide. If untreated, oral health can deteriorate and negatively impact children's general well‐being. It also has a financial cost for families and society as a whole.
School dental screening involves a dental professional examining children's mouths and teeth at school and letting parents know about their child's oral condition and treatment needs. It aims to identify oral health concerns at an early stage and prompt parents to seek treatment where required. Whether this actually improves children's oral health is the question we wanted to answer in this review.
What were the main results of this 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 studies 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).
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.
None of the studies checked whether there were any negative effects of screening programmes or how much they cost.
How up-to-date is the review?
We searched for published studies up to 15 October 2021.
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