[The effect of selected prophylactic-educational programs on oral hygiene, periodontium and caries in school children during a 4-year observation].

The aim of the work was the continuation of the evaluation of the efficacy of three prophylactic-educational programs in the field of oral cavity hygiene, status of periodontium and dental caries, and their influence on the forming of pro-health awareness and correct hygiene habits among school children. The work under discussion is the second stage of observations of the above-mentioned programs as well as the complete evaluation of 4-years examinations. The clinical and questionnaire studies were carried out in two elementary schools in Szczecin. Two hundred and twenty-three pupils were randomly allocated to three test groups: I (45 children), II (71 children), III (60 children) and control group K (47 children). In both schools mentioned above the examinations started when children were 7-8 years old and all of them were receiving planned stomatological treatment and contact fluoridation. All programs of the second stage of studies were the same as those of the first stage [49], only with the modified frequency of meetings with children. Program I, carried out in group I, was based on individual, motivating instructions of oral cavity hygiene (total 10 meetings during second stage of research). Programs II and III (group II and III accordingly) were expanded by educational activity among children and their parents. Additionally program III was enriched by professional mechanical tooth-cleaning, the use of fissure sealants, intensive dental care and proximal surface cleaning with dental floss (Tab. 1). The above-mentioned programs were carried out in co-operation with school dentists, teachers, fifth year dentistry students and students from Medical College--Oral Hygienist Faculty. After 4-years-long studies the evaluation of the three above-mentioned programs in oral cavity hygiene was achieved by using OHI-S and PI(QH). The status of periodontium was evaluated by GI and the intensity of dental caries by DMFT and DMFS. The increase of caries during the second stage of examinations was additionally evaluated and analysed thoroughly. The questionnaire studies made it possible to estimate the changes in the pro-health awareness among examined children. Reduction of OHI-S after 4 years was about 23% to 26% (Fig. 1). The status of gums shows the state of oral cavity hygiene in a better way. In control group the state remained unchanged, but in groups I, II and III it improved considerably (reduction of GI about 46% to 79%--Fig. 2). The reduction of caries in examined groups obtained after 4 years of studies was about 25% to 77% (Fig. 3) however during the second stage of research if figured out from 17% up to 72% (Fig. 4). Extreme increase of DS observed in the second stage of studies was 2.0 in control group K, a little less--1.51 in group I and 0.38 in group III (Fig. 5). The DS in group III reached the value -0.27 which proved that program III was the most efficient. The results of questionnaire studies showed a distinct improvement of health awareness among examined children. However the value of GI indicated some discrepancy between children's health knowledge and pro-health behaviour. Also it was noticed that the level of parents' education and their socioeconomic status had influence on building up good hygiene habits and on the state of caries among the examined children. The studies proved that the implementation of the above-mentioned prophylactic-educational programs or similar ones in elementary school conditions is possible with the use of hygienist under the dentist's supervision.