J Am Dent Assoc. 2023 Aug;154(8):753-759. doi: 10.1016/j.adaj.2023.05.007.
Poor oral health is significantly associated with absenteeism, contributing to millions of lost school hours per year. The effect of school-based dental programs that address oral health care inequities on student attendance has not yet been explored.
CariedAway was a longitudinal, cluster-randomized, noninferiority trial of minimally invasive medicines for caries used in a school-based program. We extracted data on school absenteeism and chronically absent students from publicly available data sets for years before, during, and after program onset (2016-2021). Total absences and the proportion of chronically absent students were modeled using multilevel mixed-effects linear and 2-limit tobit regression, respectively.
In years in which treatment was provided through a school-based caries prevention program, schools recorded approximately 944 fewer absences than in nontreatment years (95% CI, -1,739 to -149). Averaged across all study years, schools receiving either treatment had 1,500 fewer absences than comparator schools, but this was not statistically significant. In contrast, chronic absenteeism was found to significantly decrease in later years of the program (b, -.037; 95% CI, -.062 to -.011). Excluding data for years affected by COVID-19 removed significant associations.
Although originally designed to obviate access barriers to critical oral health care, early integration of school-based dental programs may positively affect school attendance. However, the observed effects may be due to poor reliability of attendance records resulting from the closing of school facilities in response to COVID-19, and further study is needed.
School-based caries prevention may also improve educational outcomes, in addition to providing critical oral health care. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03442309.
口腔健康状况不佳与缺勤显著相关，每年导致数百万个学时的损失。尚未探讨以解决口腔保健公平问题为目标的基于学校的牙科计划对学生出勤率的影响。
CariedAway 是一项针对在学校计划中使用微创药物治疗龋齿的纵向、聚类随机、非劣效性试验。我们从公开的数据集提取了项目启动前、启动期间和启动后数年的学校缺勤和长期缺勤学生的数据（2016-2021 年）。使用多级混合效应线性和 2 限 Tobit 回归分别对总缺勤人数和长期缺勤学生比例进行建模。
在提供基于学校的龋齿预防计划治疗的年份，学校记录的缺勤人数比非治疗年份减少了约 944 人（95%CI，-1739 至-149）。在所有研究年中，接受任何一种治疗的学校的缺勤人数比对照学校少 1500 人，但这并不具有统计学意义。相比之下，项目后期的长期缺勤率显著下降（b，-.037；95%CI，-.062 至-.011）。排除受 COVID-19 影响的年份的数据后，显著关联被消除。
尽管最初旨在消除获得关键口腔保健的障碍，但早期整合基于学校的牙科计划可能会对出勤率产生积极影响。然而，由于学校设施因 COVID-19 而关闭导致出勤记录的可靠性较差，观察到的效果可能是由于这一原因，需要进一步研究。
基于学校的龋齿预防除了提供关键的口腔保健外，还可能改善教育成果。这项临床试验在 ClinicalTrials.gov 上注册。注册号为 NCT03442309。
