Social-story based oral-health promotion among children with special-education needs

Abstract

Objectives: To evaluate the effects of social-story based oral health promotion among preschool children with special-education needs (SEN). Methods: This study was a randomized, controlled, blind, parallel clinical trial conducted in Special Child Care Centers in Hong Kong. A total of 307 children with SEN were randomly divided into 2 groups and received either child-friendly oral health education social stories (test) or conventional leaflets (control), which covered the topics on tooth brushing and healthy diets. After oral examinations, a brief introduction of the education materials and standard tooth-brushing training (toothbrushes and fluoridated toothpastes provided) was demonstrated to children and their parents. Parents were encouraged to read the materials to their children in daily lives. The primary outcomes were dmft and simplified oral hygiene index (S-OHI) scores. The secondary outcomes were frequencies of children’s tooth-brushing and between-meal snacking. Data were collected at baseline and 12 months. Results: 265 children were successfully followed (response rate: 86.3%). The frequency of between-meal snacking decreased in both the test and control groups after 12 months (p < 0.001), while no significant difference was found between these two groups. The proportion of increased tooth-brushing frequency was higher in the test group (38.5%) than the control group (20.0%) (p = 0.001). Lower S-OHI scores were found among children in the test group (0.53 ± 0.42) than those in the control group (0.70 ± 0.49) (p = 0.004). Likewise, the average dmft increment was lower in the test group (0.35 ± 0.80) than in the control group (0.61 ± 1.21) (p = 0.048). Conclusions: The main findings suggested that oral health education social stories were effective in modifying children’s oral-health related behaviors and improving their oral health status. Social story-based oral health promotion could be recommended for young children with SEN, and the long-term effects should be monitored.