Gains in oral health and improved quality of life of 12-13-year-old Nepali schoolchildren: Outcomes of an advocacy project to fluoridate toothpaste

Abstract

Objectives: To report on gains in oral health and improved quality of life of 12-13-year-old Nepali schoolchildren five and six years after the introduction of fluoride toothpaste in 1999. Design: Cross sectional baseline surveys in 1999 and 2001, and follow up surveys in 2004 and 2005 were multi-stage cluster sampling in design. Setting: Urban and rural schools in Central, Far Western, Mid Western and Western Developmental Regions of Nepal. Participants: 2,770, 12-13-year-olds in 1999 and 1,001, 12-13-year-olds in 2004 were examined regionally. 637 12-13-year-olds from Kathmandu valley and 448 12-13-year-olds from Tansen municipality were examined in 1999. The same schools in Kathmandu valley and Tansen were visited in 2005 and 761 and 482 12-13-years from Kathmandu valley and Tansen were examined. 6,064 8-15-year-olds in 2001 and 1,001 12-13-year-olds in 2004 participated in the collection of information on oral hygiene practice and quality of life. Method: Examinations were carried out by trained and calibrated examiners using the WHO diagnostic criteria for caries and questionnaires were interview administered by trained interviewers. Intervention: Advocacy for fluoride toothpaste between 1997 and 2002. Results: There was a 26.6% decline in caries prevalence and 38.0% decrease in 12-13-year old DMFT from 1999 to 2004 throughout four of five regions of Nepal. Approximately 65-75% of the 12-13-year-olds used fluoride toothpaste from 1999 to 2004. School specific data reveals a reduction in DMFT of 43.8% in Tansen and 53.6% in the Kathmandu valley from 1999 to 2005. From 2001 to 2004, report of oral pain decreased by 10%. Conclusions: The most likely reason for the decline in dental caries and reduction in oral pain is the widespread consumption of fluoride toothpaste by the 12-13-year-old schoolchildren. © 2006 FDI/World Dental Press.