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Community Case Study ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Public Health | doi: 10.3389/fpubh.2019.00243

School-Based Preventive Dental Program in Rural Communities of the Republic of Armenia

 Hamlet Gasoyan1, 2*, Armen Safaryan2, Lusine Sahakyan3, Nairuhi Gasoyan2,  William E. Aaronson1 and Robert A. Bagramian4, 5
  • 1Department of Health Services Administration, College of Public Health, Temple University, United States
  • 2Yerevan State Medical University, Armenia
  • 3Independent researcher, Armenia
  • 4School of Dentistry, University of Michigan, United States
  • 5American University of Armenia, Armenia

Objectives: This paper describes a school-based preventive dental program implemented in 14 rural schools within nine villages of Armenia. As part of the program, school-based toothbrushing stations (called Brushadromes) were installed in the participating schools. The intervention included school-based supervised toothbrushing with fluoride toothpaste and oral hygiene education.
Methods: The study evaluates the prevalence and levels of dental caries among rural schoolchildren in 2013 (before the implementation of the preventive program, referred as a pre-intervention group) and 2017 (four years after the start of the program, referred as an intervention group) in two randomly selected villages where the program was implemented.
A repeated cross-sectional study design was used. The prevalence of caries and the number of decayed, missing and filled teeth in permanent dentition (DMFT) and primary dentition (dmft) were recorded among 6-7 and 10-11-year-old schoolchildren in 2013 (n = 166) and 2017 (n = 148). The pre-intervention and intervention groups include different children in the same age range, from the same villages, examined at different time points. In both instances, they represented over 95% of the 6-7 and 10-11-year-old student populations of the studied villages.
Pearson Chi-square, Fisher’s Exact test, independent t-test, and quasilikelihood Poisson regression were utilized for data analysis.
Results: Schoolchildren involved in the intervention had significantly less decay levels compared to same-ages pre-intervention groups. For 10-11-year-old schoolchildren involved in the program, the mean number of permanent teeth with caries was lower by a factor of 0.689 (lower by 31.1%), p = 0.008, 95% CI, 0.523; 0.902, compared to the 10-11-year-old pre-intervention group, after controlling for age, sex, child’s socio-economic vulnerability status, the village of residence, and the number of permanent teeth with fillings.
Conclusions: The study indicates a significantly lower level of caries among schoolchildren in the studied two villages where the intervention was implemented. The described intervention is particularly suitable in rural settings where water fluoridation is not available, and homes have limited availability of running water.

Keywords: Caries prevention, primary school children, fluoride toothpaste, Armenia, School-based intervention

Received: 04 May 2019; Accepted: 13 Aug 2019.

Copyright: © 2019 Gasoyan, Safaryan, Sahakyan, Gasoyan, Aaronson and Bagramian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Hamlet Gasoyan, Department of Health Services Administration, College of Public Health, Temple University, Philadelphia, United States, hamlet.gasoyan@temple.edu