REVIEW ARTICLE

Preventive Oral Healthcare Programs Worldwide:

A Narrative Review
Priyanga Chandrashekar1, Rene Selestina JP2

Received on: 10 April 2023; Accepted on: 05 May 2023; Published on: 15 July 2023

A b s t r ac t
 ral diseases are becoming an increasing global burden. Children and adolescents suffer more from acute infection, dental pain, and discomfort
O
caused due to these oral diseases. Untreated caries affect a child’s ability to eat, speak, learn, and sleep. Severe untreated caries in children
affect nutrition, growth, and weight gain. Preventive oral healthcare programs are an economical and powerful means of raising community
health in future generations. Some of the oral healthcare programs conducted worldwide are the Healthy Teeth, Happy Smiles!, Blue Book oral
health program, Smile Train India, Childsmile, MaliMali program, Love Teeth day, Colgate’s “young India” Bright Smiles, Bright Futures, Chacha
Nehru Sehat Yojna school health scheme (SHS), Neev School Oral Health Program, Pit and fissure sealant pilot project, and Let’s 8020. Oral health
education is effective in enhancing the knowledge and oral health-related behaviors in the target population. Only with the coordinated and
synergistic efforts of all stakeholders will progress in areas of oral health governance, oral health promotion and disease prevention, the oral
health workforce, oral health services, and oral health information systems be possible.
Keywords: Behavior, Dental health, Health education, School, Smile.
Journal of Scientific Dentistry (2023): 10.5005/jp-journals-10083-1036

Introduction 1,2
Department of Public Health Dentistry, Indira Gandhi Institute of
Oral diseases are becoming an increasing global burden. According Dental Sciences, Puducherry, India
to the global oral health status report, about 3.5 billion people are Corresponding Author: Priyanga Chandrashekar, Department of
affected worldwide. The major oral diseases in accordance to the Public Health Dentistry, Indira Gandhi Institute of Dental Sciences,
report are untreated caries of permanent teeth (2 billion cases), Puducherry, India, Phone: +91 9344991778, e-mail: priyanga1311@
severe periodontal disease (1 billion cases), untreated dental caries gmail.com
in deciduous teeth (510 million cases), and edentulism (350 million How to cite this article: Chandrashekar P, Rene Selestina JP. Preventive
cases).1 Oral Healthcare Programs Worldwide: A Narrative Review. J Sci Den
Children and adolescents have higher oral pain and suffering 2023;13(1):25–27.
as well as severe infections. A child’s ability to eat, speak, learn, and Source of support: Nil
sleep is impacted by untreated dental caries. Children with severe, Conflict of interest: None
untreated caries experience problems with nutrition, development,
and weight gain.2 Their attendance at school is also impacted by
toothaches, which lowers their academic achievement. Young Various oral healthcare programs have been conducted worldwide
children are typically hospitalized for the removal of carious teeth to create awareness about the seriousness of oral diseases, reduce
under general anesthesia in several high-income nations.1 People their prevalence, and promote the overall health of children. This
from more underprivileged origins are disproportionately affected review is about some of the different unnoticed preventive oral
by the effects of oral illnesses. care programs that have been conducted worldwide.
In order to meet children’s demands for overall health, good oral
health is crucial. The most prevalent and undertreated disorders in V a r i o u s P r e v e n t iv e O r a l H e a lt h c a r e
children are tooth decay and gum disease. For many kids, dental
illness makes it difficult to eat, sleep, speak, play, learn, and smile.
Programs
Children who have poor oral health are 12 times more likely to have Healthy Teeth, Happy Smiles!
more days with limited activities. Oral disorders cause more than An early intervention program called “Healthy Teeth, Happy
50 million hours of lost school time each year.3 Most oral illnesses Smiles!” that starts from birth is based on the Childsmile oral health
or problems that affect youngsters can be avoided or treated. It improvement initiative of the Scottish Government (NHS Scotland,
is crucial that young people acquire the knowledge and abilities ND), which is in accordance with more current evidence summaries
needed to achieve and maintain excellent health, particularly dental in England (National Institute of Health and Care Excellence, 2014;
health. It is extremely crucial to promote oral health in schools.4 Public Health England, 2013). Including oral health in other areas
Dental problems include discomfort and tooth loss, which have an of health and care, enhancing children’s, parents’, and carers’
impact on a child’s look, quality of life, ability to eat properly, and personal skills, and promoting collaboration with the local dentistry
ultimately their growth and development.1 community to enhance prevention and raise awareness of oral
Programs that promote preventive oral health are a potent and health in early childhood settings were the program’s strategic
affordable way to improve community health for future generations. components.5

© The Author(s). 2023 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.
org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to
the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
 Oral Healthcare Programs

Blue Book Oral Health Program The goals were to promote community participation in oral health
To promote general health engagement in oral health promotion education initiatives and to promote individual awareness of and
and to address the critical issue of early childhood caries (ECC), the engagement in dental self-care. The public was informed about oral
Blue Book Program was created to give parents of newborns and health issues via a variety of mass media, including radio, television,
early children in New South Wales (NSW), Australia, and child health and newspapers.10
professionals accurate and appropriate oral health information.
Colgate’s “Young India” Bright Smiles, Bright Futures
The NSW Department of Health provides the Personal Health
Record of New South Wales (NSW), also known as the “Blue Book,” In order to provide children with oral health education, Colgate-
to each parent of a newborn child in NSW, Australia. It is intended Palmolive and IDA joined together in 1976. In 2001, a campaign
to be a tool that family doctors, pediatricians, and other general was started in Agra to promote oral health in schools. Its goals
practitioners can use to document information on a child’s health, were to minimize the prevalence of dental caries, encourage
development, and growth and to provide parents and other primary preventative healthcare behaviors, and give kids the knowledge
carers with timely guidance.6 they need to practice excellent oral hygiene. Children in elementary
schools between the ages of 6 and 14 are taught appropriate oral
Smile Train India hygiene practices, the importance of night brushing and the correct
International children’s charity Smile Train has a long-term solution brushing methods utilizing a tooth model and a toothbrush, where
for the solvable issue of cleft lip and palate. The “teach a man to fish” the value of a consistent oral hygiene routine is firmly ingrained
philosophy of the program is used to train local doctors to conduct in them. Each child receives a “Dental Health Pack” at the end of
cleft repairs in their own communities. These doctors then train new the program, which includes a toothbrush and toothpaste as well
medical professionals, building a long-lasting, sustainable system. as attractive charts with helpful oral care advice. This is done to
Contributions assist local hospitals in underdeveloped nations encourage the youngsters to practice healthy oral hygiene habits,
in providing year-round, completely free cleft repair surgery for such as brushing their teeth twice daily. Each classroom has a chart
children in need.7 with information about oral hygiene so that students may refer to it
and teachers can reinforce the message. Teachers at schools receive
Childsmile training and a “Teacher’s Handbook” to assist them in permanently
The 2005 policy document for the Scottish Executive served as the ingraining healthy oral hygiene practices. The Teacher’s Guide is a
catalyst for the Childsmile initiative. An action plan for modernizing thorough manual designed to assist instructors in promoting the
dentistry care and promoting oral health in Scotland. By shifting importance of having Healthy Teeth. It employs graphics to illustrate
the emphasis of treatment toward more proactive, preventative the anatomy of a tooth, the phases of tooth decay, and the reasons
measures and promoting health improvement from a young of gum problems.11
age, it sought to improve children’s oral health in Scotland and
reduce gaps in dental access and dental health. They focused on
Chacha Nehru Sehat Yojna School Health Scheme
clinical prevention in primary dental care, health visitor-led health (SHS)
promotion, and community development-based projects. The In order to offer comprehensive health services to school-
initiative is based on the WHO Ottawa Charter’s 15 health promotion age children, with the creation of six school health clinics, the
framework, which calls for promoting supportive settings, boosting Government of Delhi Directorate of Health Services founded
community action, enhancing individual abilities, and refocusing SHS in 1979. Under the seventh five-year plan, the program was
health services.8 expanded, and 64 school clinics were opened. Two government
institutions, Maulana Azad Institute of Dental Sciences and DDU
MaliMali Program Hospital, which both perform routine screening programs and act
A school-based initiative – the MaliMali Program (MaliMali means as referral facilities, are responsible for the dental portion of the
“smile” in Tongan) to enhance children’s oral health is planned and school health program.12
run by South Pacific Medical Team (SPMT). In addition to additional
activities, The MaliMali Program comprises the following three Neev School Oral Health Program (SOHP)
primary programs: a program that instructs kindergarten and Neev SOHP would be implemented as a pilot project in all
primary school pupils on how to avoid cavities (including leaflet government schools in Delhi State run by the Government of
distribution, lectures, and suggestions on what to eat between NCT (National capital territory) of Delhi. A district plan would be
meals), a project that promotes using fluoride toothpaste and offers created by the dental team and mobile dental clinic that would
toothbrushing tips, and a fluoride mouthwash delivery program include all the schools throughout the year. The main goal is to
(FMR). The MaliMali program has been promoted by the Tongan schedule dental screenings and checkups and promote oral health
team for preventive dentistry, which is made up of dentists and through dental health education. By using a mobile dental clinic
dental therapists affiliated with the Dental Office of the Tongan in the schools, it provides primary and secondary dental care and
Ministry of Health.9 provides appropriate referrals for the Maulana Azad Institute of
Dental Sciences’ superior care. All pupils in grades 6 through 10 from
“Love Teeth Day” all public schools in each Delhi State district (at least 50 schools)
Since 1989, China has celebrated “Love Teeth Day” on September will participate in the initiative for 1 year. Parents, school officials,
20th across the country. The promotion of preventative oral and teachers are all given training and made a part of the team,
public healthcare and oral health education was pushed upon all eventually integrating into the current school-based healthcare
Chinese citizens. The National Committee for Oral Health and local system. The program is projected to cost Rs. 2,00,00,000 in total
committees at the provincial, county, and municipal levels planned annually, and it will benefit over 80,000 schoolchildren in one
and carried out the main actions to encourage preventive oral care. district of the state.13

26 Journal of Scientific Dentistry, Volume 13 Issue 1 (January–June 2023)

 Oral Healthcare Programs

Pit and Fissure Sealant Pilot Project – National Oral References

Health Program (NOHP), AIIMS, New Delhi 1. Jain N, Dutt U, Radenkov I, Jain S. WHO’s global oral health status
The current pit and fissure sealant project was started as part of report 2022: Actions, discussion and implementation. Oral Dis 2023.
NOHP’s major component, and representatives from 12 dental DOI: 10.1111/odi.14516.
colleges were trained for it on May 1, 2017. Its objective is to prevent 2. Promoting Children’s Oral Health. California Childcare Health
Program. California; 2006.
dental cavities in children between the ages of 6 and 14 by sealing
3. WHO Information Series on School Health, Oral Health Promotion:
53,750 permanent molars.14 An Essential Element of a Health-Promoting School. World Health
Organization: Geneva; 2003.
Let’s 8020 4. Bertness J, Holt K, editors. Promoting Oral Health in Schools:
The 8020 Promotion Foundation was created on December 1, A Resource Guide. Washington, DC; 2009.
2000, with the help of a number of social groups and commercial 5. Murphy JM, Burch TE, Dickenson AJ, Wong J, Moore R. An evidence‐
enterprises, as requested by the Japan Dental Association based oral health promotion programme: Lessons from Leicester.
and approved by the Ministry of Health and Welfare. The 8020 Oral Dis 2018;24(1–2):38–43. DOI: 10.1111/odi.12743.
Campaign was started to assist people in keeping 20 or more of 6. Phelan C. The Blue Book Oral Health Program: A Collaborative
Partnership with Statewide Implications. Health Promot J Austr
their own teeth until they are 80 years old. This was done after
2006;17(2):109–113. DOI: 10.1071/he06109.
the foundation established the purpose of assisting the elderly 7. Smile Train India | Free Cleft Lip and Palate Surgeries [cited April 6,
to better and preserve their healthy lives. By the involvement of 2023]. Available from: https://www.smiletrainindia.org/.
numerous industries and the implementation of activities aimed at 8. Turner S, Brewster L, Kidd J, Gnich W, Ball GE, Milburn K, et al.
all generations, the campaign chose a lifelong strategy to prevent Childsmile: The national child oral health improvement programme in
tooth loss.15 Scotland. Part 2: Monitoring and delivery. Br Dent J 2010;209(2):79–83.
DOI: 10.1038/sj.bdj.2010.629.
9. Takeuchi R, Kawamura K, Kawamura S, Endoh M, Tomiki S, Taguchi
C o n c lu s i o n C, et al. A program to improve the oral health of school children in
Oral health education is effective in enhancing the knowledge and the Kingdom of Tonga: The MaliMali Program. Int J Oral-Med Sci
oral health-related behaviors in the target population. Therefore, 2012;11(1):30–37. DOI: 10.5446/IJOMS.11.30.
involving important individuals in oral health education for school- 10. Dai J, Hao Y, Li G, Hu D, Zhao Y. ‘Love Teeth Day’ campaign in China
aged kids – especially teachers and parents — would lead to a larger and its impact on oral public health-the twentieth anniversary. Br
Dent J 2010;209(10):523–526. DOI: 10.1038/sj.bdj.2010.1039.
degree of improvement in kids’ dental health. All stakeholders
11. Smiles CB. Bright futures. “Bright Smiles, Bright Futures: An Oral
will continue to be motivated to take action as oral illnesses are Health and Early Literacy Program for Head Start and Early Childhood
acknowledged as major worldwide public health issues. Progress Programs”. New York: Colgate Bright Smiles, Bright Futures; 2003.
in areas such as oral health governance, oral health promotion 12. School Health Service in Delhi | PSM Made Easy [cited April 10, 2023].
and disease prevention, the oral health workforce, oral health Available from: https://ihatepsm.com/blog/school-health-service-
services, and oral health information systems will only be possible delhi.
with the coordinated and synergistic efforts of all stakeholders, 13. “Neev” School Oral Health Program | GCDFund: E-Depositary (Indian
including governments, the UN system, intergovernmental bodies, Strategy) [cited April 6, 2023]. Available from: https://www.gcdfund-
india.org/projects/neev-school-oral-health-program.
nonstate actors, NGOs, professional associations, youth and student
14. Current Initiatives | e-DantSeva [cited April 6, 2023]. Available from:
organizations, patients’ groups, academia, research institutes, and https://edantseva.gov.in/content/current-initiatives.
patient groups. 15. 8020推 進 財団 [cited April 6, 2023]. Available from: https://
www.8020zaidan.or.jp/index.html.
Orcid
Rene Selestina JP https://orcid.org/0000-0003-3076-6050

Journal of Scientific Dentistry, Volume 13 Issue 1 (January–June 2023) 27