***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES Determine the impact of an oral health education program on oral hygiene and the awareness level of elementary schoolchildren . METHODS A total sample of 247 schoolchildren between the ages of 7 and 15 years from the public school system of Parnamirim , Brazil , were selected and r and omly allocated to a control ( n=115 ) and experimental ( n=132 ) group .  Sociodemographic data were recorded and a clinical examination was given to establish the decayed , missing and filled surfaces index ( DMFS ) and the dmfs index . The visible plaque index ( VPI ) and gingival bleeding index ( GBI ) were collected before and after the intervention . A closed- question question naire was applied to the schoolchildren before and after intervention to determine their knowledge of oral health . The experimental group took part in oral health education activities over a 4-month period . RESULTS The VPI ( P = 0.014 ; CI 0.24 - 0.86 ) and GBI ( P = 0.013 ; CI 0.28 - 0.87 ) of the experimental group were significantly lower after educational activities . Similarly , the experimental group also obtained a higher number of correct answers on the question naire ( P < 0.0001 ; CI 3.73 - 26.81 ) . However , there was no association between oral hygiene indicators , VPI ( P = 0.311 ; CI 0.23 - 1.60 ) , and GBI ( P = 0.927 ; CI 0.43 - 2.16 ) , and the information level of the schoolchildren . CONCLUSIONS Context ualized educational activities in the school routine had positive effects on oral hygiene and the level of information about oral health , although the more informed individuals did not always practice better oral hygiene Background Oral health education ( OHE ) in schools has largely been imparted by dental professionals . Considering the substantial cost of this expert-led approach , the strategies relying on teachers , peer-leaders and learners themselves have also been utilized . However the evidence for comparative effectiveness of these strategies is lacking in the dental literature . The present study was conducted to compare the effectiveness of dentist-led , teacher-led , peer-led and self-learning strategies of oral health education . Methods A two-year cluster r and omized controlled trial following a parallel design was conducted . It involved five groups of adolescents aged 10 - 11 years at the start of the study . The trial involved process as well as four outcome evaluations . The present paper discusses the findings of the study pertaining to the baseline and final outcome evaluation , both comprising of a  self-administered  question naire , a structured interview and clinical oral examination . The data were analyzed using Generalized Estimating Equations . Results All the three educator-led strategies of OHE had statistically higher mean oral health knowledge ( OHK ) , oral health behavior ( OHB ) , oral hygiene status ( OHS ) and combined knowledge , behavior and oral hygiene status ( KBS ) scores than the self-learning and control groups ( p<0.001 ) . The mean OHK , OHS and KBS scores of the three educator-led strategies did not differ significantly . The peer-led strategy was , however , found to have a significantly better OHB score than the respective score of the teacher-led strategy ( p<0.05 ) . The self-learning group had significantly higher OHB score than the control group ( p<0.05 ) but the OHK , OHS and KBS scores of the two groups were not significantly different . Conclusions The dentist-led , teacher-led and peer-led strategies of oral health education are equally effective in improving the oral health knowledge and oral hygiene status of adolescents  . The peer-led strategy , however , is almost as effective as the dentist-led strategy and comparatively more effective than the teacher-led and self-learning strategies in improving their oral health behavior . Trail registration S RCT Parents and school staff play important roles in promoting children 's oral health . Our study goals were to investigate whether an intervention targeting parents and school staff can improve the oral-health behavior and oral-health status of schoolchildren . Three-hundred and ninety-two schoolchildren in six schools in Tehran participated in a group r and omized trial from September 2010 to March 2011 . Schools were r and omly allocated into three groups : comprehensive , student , and control . Intervention in the comprehensive group consisted of strategies to encourage children , their parents , and school staff to increase the frequency of toothbrushing and flossing . In the student group , the intervention targeted only children . The control group received no intervention . The primary outcome was change in oral-health behaviors ( brushing and flossing ) , while the secondary outcomes were changes in oral hygiene and Community Periodontal indices and in Health Belief Model components . Multilevel modeling was employed for data analyses . Students who were in the comprehensive intervention group  brushed and flossed significantly more frequently compared with those in the student intervention group . Although students ' gingival health improved significantly in the comprehensive intervention group , such significant improvement was not seen in the student group . In conclusion , promising results are seen when the oral-health education targets both school and home setting OBJECTIVE Using a cluster r and omized trial , this study tested the effectiveness of a dental health education program design ed to improve the oral hygiene and dental knowledge of 10-year-old children . METHODS Thirty-two primary schools in the northwest of Engl and participated . After a baseline assessment of plaque and the completion of a dental knowledge question naire by the children , the schools were allocated r and omly to active or control groups . Children in schools allocated to the active group received the dental health program , which consisted of four one-hour lessons . After four months the children were examined clinical ly and scored for plaque , and a second question naire was administered . The schools in the control group were then allocated r and omly to receive the program or not over the following three months , the program being withdrawn from the schools who initially received it . A further assessment of plaque was made and a question naire administered seven months after the baseline of the study . RESULTS The active groups had 20 percent and 17 percent lower mean plaque scores than the control group at four and seven months ( P < .001 ) . The children 's knowledge of which type of toothbrush should be used and the role of disclosing tablets improved in the initial test group when compared with the control group and this was retained over the second part of the study . CONCLUSION The children receiving the program had significantly lower mean plaque scores and greater knowledge about toothbrushes and disclosing tablets than the control children who had not received the program The development of chronic inflammatory periodontal diseases is strongly correlated with the growth and maturation of subgingival bacterial colonies . Consequently a major preventive goal should be the control of plaque formation . We conducted a r and omized , controlled trial to examine the short-term effect of an intensive instructional program without professional prophylaxis on the  gingival health  of 240 , 11 - 14 year old school children .  Plaque index ( PlI ) , gingival index ( GI ) , bleeding index ( BI ) and probing pocket depth ( PD ) were examined 4 x by 1 examiner blinded to the instruction . During the period of instruction , subjects in the experimental groups were involved in a plaque and gingivitis prevention program provided in separate educational sessions . One of the experimental groups ( E-1 ; n = 80 ) was provided with a new toothbrush , toothpaste and instruction while the second experimental group ( E-2 ; n = 80 ) was provided with toothbrush , toothpaste , dental floss and instruction . In the control group ( C ; n = 80 ) only dental examinations were provided : no preventive program or oral health measures were conducted . Examinations were conducted every 3 months during the instructional period and at 6 months following the completion of the active preventive programme . During the experimental period there was a significant decrease ( p < 0.001 ) in the mean PlI , GI and BI of the experimental groups following the program while in controls there was a slight but not significant increase of mean values ( p > 0.05 ) . During the preventive program experimental groups exhibited small but not significant ( p > 0.05 ) reductions of PD . Experimental group 1 showed similar PlI , GI , BI and PD scores as experimental group 2 during the study . After the instructional program was completed and a period of 6 months had passed , there was a large and significant ( p < 0.001 ) increase of mean PlI , GI and BI scores in both experimental groups back to the baseline levels . We conclude that a short-term preventative program without professional instrumentation induces a transient improvement of  gingival health of schoolchildren but only during the instructional period . The maintenance of improved gingival health over longer time periods requires prolonged , repeated instruction by professionals . These measures may be difficult to institute and are of question able cost-effectiveness The goal of this study was to evaluate a 15-month educational program design ed to children . The sample consisted of 60 six-year olds , r and omly assigned into control and experimental group . The control consisted of tooth brushing training , once a year . The experimental group received intensive individual tooth brushing training every three months and guidance on oral health .  Initially , both groups were assessed using plaque , gingival , dmfs and DMF-S indexes every three months . In the control , no statistically significant difference was observed for plaque and gingival indexes . The experimental group showed a statistically significant reduction in mean values for two indexes . The caries indexes showed no statistically significant difference . The proposed educational program developed was efficient in reducing gingival and plaque indexes as well caries incidence BACKGROUND The lack of national oral health policy and organized school dental health programs in the country call for affordable , accessible , and sustainable strategies . OBJECTIVES The objective was to compare the oral hygiene , plaque , gingival , and dental caries status among rural children receiving dental health education by qualified dentists and school teachers with and without supply of oral hygiene aids . MATERIAL S AND METHODS This interventional study was conducted among 15-year-old children selected r and omly from four schools in Nalgonda district between September 2009 and February 2010 . Schools were divided into four different intervention groups . The intervention groups varied in the form of intervention provider and frequency of intervention one of which being the control group . The oral hygiene , plaque , gingival , and dental caries status was assessed at baseline and 6 months following the intervention . SPSS 16 was used for analysis . RESULTS The preintervention and postintervention comparison within each group revealed a substantial reduction in mean oral hygiene index-simplified ( OHI-S ) , plaque index ( PI ) , and gingival index ( GI ) at postintervention compared to baseline in group 4 ( 1.26 , 0.87 , and 0.74 , respectively ) followed by group 3 ( 0.14 , 0.37 , and 0.12 , respectively ) . The OHI-S , PI , and GI scores increased in group 1 ( 0.66 , 0.37 , and 0.34 , respectively ) and group 2 ( 0.25 , 0.19 , and 0.14 , respectively ) . Mean decayed , missing filled surfaces score between the groups was not statistically significant at baseline and postintervention . CONCLUSION The dramatic reductions in the OHI-S , PI , and GI scores in the group supplied with oral hygiene aids call for supplying low cost fluori date d toothpastes along with toothbrushes through the school systems in rural areas The aim of the present study is to assess the behaviour of different motivation methods on levels of oral hygiene among schoolchildren aged from 7 to 9 years in Araraquara , SP , Brazil . The methods tested were : indirect instruction using ' The Smiling Robot ' ( group I ) , indirect instruction through class presentation ( group II ) and direct instruction with macromodels ( group III ) . A control group was also constituted , which received no kind of motivation ( group IV ) . The O'Leary Plaque Index was used as the evaluation method , applied before the instruction and 30 days after application of the different methods . It was noted that the plaque index had not decreased in group IV only . In conclusion , all the motivation methods promoted significant decrease of plaque index and among these methods , the ' The Smiling Robot ' was the one that provided the best results BACKGROUND To enhance the well-being of secondary school pupils by improving their eating habits , especially school-based eating , a joint project , including oral health intervention , was conducted during the academic year 2007 - 2008 . AIM The aim was to study the effect of a dietary intervention on schoolchildren 's  eating habits and laser fluorescence ( LF ) values of teeth . METHODS Twelve schools in three cities , Finl and , were r and omly assigned to be intervention and control schools . Two of the intervention schools were further assigned in the instruction of oral hygiene . In 2007 and 2008 , the pupils ( n=739 and 647 , respectively ) answered a question naire on dietary and oral health habits , and LF values on the occlusal surfaces of molars and premolars were determined . RESULTS The frequency of eating a warm meal and drinking water at school to quench thirst increased in the intervention schools but decreased in the control schools ( P<0.001 and P=0.005 , respectively ) . LF values in molars decreased in schools with dietary intervention only ( P=0.024 ) . CONCLUSIONS The 1-year dietary intervention was long enough to show improvement in eating habits and in habits for quenching thirst , and some decrease in the LF values of molars OBJECTIVES To assess effectiveness of an oral health education ( OHE ) programme on oral hygiene knowledge , practice s , plaque control and gingival health of 13- to 15-year-old school children in Bangalore city . METHODS Three schools were r and omly selected and 
    Output:
    
There was not enough evidence on the effectiveness of the interventions in reducing dental caries .
CONCLUSIONS Traditional oral health educational actions were effective in reducing plaque , but not gingivitis .
There is no long-term evidence in respect of the effectiveness of these interventions in preventing plaque accumulation , gingivitis and dental caries in the school environment