Effectiveness of school-based oral health education interventions on oral health status and oral hygiene behaviors among schoolchildren: an umbrella review.

Objective: To summarize evidence of the effectiveness of school-based oral health education interventions on oral health status and oral hygiene behaviors among schoolchildren.

Methods: A comprehensive search was conducted across seven databases MEDLINE Ovid, Google Scholar, Web of Science, Scopus, EBSCO-APA PsycInfo, ProQuest, and CINAHL, with two independent reviewers screening titles and abstracts including full texts. Data extraction procedure and quality appraisal of this umbrella review adhered to the JBI critical appraisal checklist. Systematic reviews of RCTs in which schoolchildren of 5 to 18 years of age received oral health education in a classroom-based school setting from dentists, schoolteachers, or caregivers were included. Key outcome measures included distinct oral health indices, as well as knowledge, attitudes, and practices.

Results: A total of 27 relevant systematic reviews were included for the umbrella review. Methodological quality was substantial among most systematic reviews, thus enhancing the strength of reliability of findings. Nineteen were graded excellent (scores 30 to 33), four were classified as good quality (scores 26 to 29), four rated as fair quality (scores 21 to 25) and none rated as poor-quality (scores 20 or below). Numerous studies from various nations were identified, with reviews peaking in 2019 and 2021. The overlap assessment reveals slight degree of overlap (3.73% overlap, -0.45% CCA-corrected covered area). Meta-analyses show that oral health education interventions had a favorable impact on a number of outcomes, such as reduced plaque and gingivitis, enhanced knowledge, attitude, and behavior, and improved oral cleanliness.

Conclusion(s): This umbrella review provides a comprehensive synthesis of the effectiveness of oral health education interventions in school settings. Positive outcomes in plaque reduction and gingivitis prevention affirm the benefits of these programs, though the evidence for caries prevention remains inconclusive. The findings highlight the broader impact of these interventions on students' knowledge, attitudes, and behaviors, emphasizing the need for tailored approaches and further research to optimize oral health education. This review serves as a valuable resource for educators, healthcare professionals, and policymakers dedicated to improving pediatric oral health.

Prospero Registration Number: CRD42023401903.