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J Clin Pediatr Dent. 2017;41(3):204-213. doi: 10.17796/1053-4628-41.3.204.

Effect of a School-Based Supervised Tooth Brushing Program In Mexico City: A Cluster Randomized Intervention.


Large-scale school-based programs effectively provide health education and preventive strategies. SaludARTE is a school-based program, including supervised tooth brushing, implemented in 51 elementary schools in Mexico City.


To assess the three-month efficacy of supervised tooth brushing in reducing dental plaque, gingival inflammation, and bleeding on probing in schoolchildren participating in SaludARTE.


This was a pragmatic cluster randomized intervention, with two parallel branches. Four randomly selected schools participating in SaludARTE (n=200) and one control school, which did not participate in the program (CG) (n=50), were assessed. Clusters were not randomly allocated to intervention. The main outcomes were as follows: mean percentage gingival units with no inflammation, dental surfaces with no dental plaque, and gingival margins with no bleeding. The independent variable was supervised tooth brushing at school once a day after a meal. Guardians and children responded to a questionnaire on sociodemographic and oral hygiene practices, and children were examined dentally. Mean percentage differences were compared (baseline and follow-up).


A total of 75% of guardians from the intervention group (IG) and 77% from the CG answered the questionnaire. Of these, 89.3% were women, with a mean age of 36.9±8.5 years. No differences in sociodemographic variables were observed between groups, and 151 children from the IG and 35 from the CG were examined at baseline and follow-up. Mean percentage differences for plaque-free surfaces (8.8±28.5%) and healthy gingival units (23.3%±23.2%) were significantly higher in the IG.


The school-supervised tooth brushing program is effective in improving oral hygiene and had a greater impact on plaque and gingivitis than on gingival bleeding. It is necessary to reinforce the oral health education component of the program.


dental plaque; gingival bleeding; oral health education; school program; tooth brushing

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