***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: AIM Oral health is a reflection of general health and significantly influences the quality of life . Dental caries is one of the most common chronic diseases of childhood which may adversely affect physical , mental and social growth of children . Oral hygiene methods can effectively prevent oral and dental diseases , and oral hygiene education plays an important role in this regard . The aim of the present study was then to assess the effect of oral hygiene education on the oral and dental health  of 6-year-olds . MATERIAL S AND METHODS A hundred and sixty 6-year-old children from 4 pre-school centers were divided into two groups , case and control , in this cluster r and omised controlled trail . The children in the case group received oral and dental education in one session . The parents of the case group were also instructed in one session . The children and parents of the control group did not receive any instructions .  Plaque index ( PI ) : Turesky-Gilmore-Glickman ; gingival index ( GI ) : Loe & Silness ; at a ) baseline , b ) 1.5 and c ) 6 months after the first examination . Data were analysed by repeated measure ANOVA . RESULTS PI : A significant difference was found between the baseline examination and the first follow-up ( p < 0.01 ) , and between the baseline examination and the second follow-up ( p < 0.001 ) . GI : Although values in the case group were lower , no statistically significant difference was found between the two groups and within each group ( p > 0.05 ) . Regarding the number of brushing times , a statistically significant difference was found between the first and the second follow-ups of the study groups ( p > 0.05 ) . The brushing type and the application of other hygienic measures did not show any difference ( p > 0.05 ) . CONCLUSION Within the limitations of the present study it may be concluded that oral hygiene instruction to 6-year-old children and their parents improves their dental health OBJECTIVES The aim of this study was to evaluate the effect of a 6-year oral health education programme in primary schoolchildren . METHODS This programme was part of the Signal-T and mobiel project , a longitudinal collaborative project combining the registration of oral health data and oral health promotion . The intervention group comprised 3291 children with a mean age of 7.1 years ( SD 0.43 ) at the start of the programme . Every year these children were examined clinical ly and a question naire , to be filled in by the parents , was administered to assess oral health behaviour . These children received an oral health education programme which consisted of a yearly 1-h instruction . Data collected using the same question naire and clinical examination in 676 12-year-old children were included as control group . The sample s were obtained using stratified cluster sampling . The effect of the interventional programme was assessed by measuring differences in caries prevalence and incidence , levels of dental care and reported oral health behaviour . RESULTS Mean DMFT/S values , although higher in the control group , were not significantly different . The reported frequency of brushing was the same in both groups . Significant differences in favour of the intervention group were found in the number of between-meal snacks ( P < 0.001 ) and the proper use of topical fluorides ( P < 0.05 ) . Children in the control group showed a significantly lower proportion of filled teeth than those in the intervention group ( P < 0.01 ) , with a care index of 73 % versus 80 % . CONCLUSION In conclusion , the implemented minimal school-based oral health education programme did not result in a significant reduction of the caries prevalence measured . The programme has been effective in improving reported dietary habits and the proper use of topical fluorides and result ed in a higher care index OBJECTIVE The study aim ed to estimate the relationship between dental anxiety and past dental treatment experience in Lithuanian adolescents and to examine a possible influence of gender and area deprivation on dental anxiety . MATERIAL AND METHODS A total of 885 adolescents in 22 r and omly pre-selected areas were clinical ly examined and completed a question naire regarding dental anxiety . Dental anxiety was estimated using the Corah 's Dental Anxiety Scale ( DAS ) . Past invasive dental treatment experience was defined as the number of extracted and filled teeth . RESULTS The total mean ( SD ) score of the DAS was 10.07 ( 3.20 ) . High levels of dental anxiety were reported in 11.3 % of Lithuanian adolescents . The mean ( SD ) DAS score among adolescents who had no treatment experience was 9.51 ( 3.02 ) , whereas adolescents who had treatment experience , had significantly higher mean ( SD ) DAS score , i.e. 10.25 ( SD 3.23 ) . CONCLUSIONS The past dental treatment experience and dental anxiety were related in Lithuanian adolescents . Adolescents with no past invasive dental treatment experience were less anxious than those who had such experience . Girls reported higher dental anxiety than boys , while area deprivation had no effect on dental anxiety 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 PURPOSE To describe oral health status and to evaluate the effectiveness of a caries prevention programme in preschool children . MATERIAL S AND METHODS A sample of 1656 3- to 7-year-old children were examined in kindergartens in 2002 , and 411 3-year-old children were then selected to participate in the prevention programme . The test group A ( n = 156 ) , group B ( n = 118 ) , and the control group ( n = 137 ) were defined for the study . For test group A , supervised toothbrushing was prescribed and for test group B , fluoride gel applications were used . For the control group , children did not undergo any of the aforementioned procedures . Dental caries was assessed according to the World Health Organization ( WHO ) criteria , and oral hygiene according to the Greene-Vermillion simplified oral hygiene index . Preventive programmes were based on oral hygiene instructions , supervised daily toothbrushing , and fluoride gel applications . The relationship between oral hygiene and severity of dental caries was determined by using Fisher 's test . RESULTS The prevalence of dental caries varied between 39.7 % and 90.8 % , and the decayed , missing , and filled teeth ( dmf-t ) varied between 1.3 + /- 0.16 and 5.0 + /- 0.24 . Oral hygiene was satisfactory in 43.2 % of children . During the 3 years of the programme , a significant difference was found between the test and the control groups . The reduction in test group A was 45.4 % and in test group B was 60.1 % . CONCLUSIONS The prevalence and severity of dental caries among the examined children increased with age , and was lower in both the test groups compared with the control group . The professional fluoride applications and proper oral hygiene showed the most effective results in caries prevention The aim of our study was to compare the changes in children 's oral health-related behavior , knowledge , and attitudes obtained using an oral health-promotion approach , a risk- strategy and promotion approach , and reference area , and to report changes in the behavior of children between the experimental and the control groups of a r and omized clinical trial ( RCT ) . The study population consisted of all fifth and sixth grade rs who started the 2001 - 2002 school year in Pori , Finl and ( n = 1,691 ) , where the RCT and program of oral health promotion were implemented for 3.4 yr . Children with at least one active caries lesion were r and omly assigned to experimental ( n = 250 ) and control ( n = 247 ) groups . Children in Rauma ( n = 807 ) acted as the reference . Changes in children 's self-reported behavior , knowledge , and attitudes were compared between groups . The subjects in the oral health-promotion group and in the risk- strategy and promotion group in Pori tended to show greater improvement in most of their oral health-related behaviors than those in the reference group , and children in the RCT experimental group showed greater improvement in most of their oral health-related behaviors than those in the RCT control group . Children can be helped to improve their oral health-related behavior by intervention , including oral hygiene and dietary counseling , or by implementing a multilevel-approach oral health-promotion program The aim of the work was the continuation of the evaluation of the efficacy of three prophylactic-educational programs in the field of oral cavity hygiene , status of periodontium and dental caries , and their influence on the forming of pro-health awareness and correct hygiene habits among school children . The work under discussion is the second stage of observations of the above-mentioned programs as well as the complete evaluation of 4-years examinations . The clinical and question naire studies were carried out in two elementary schools in Szczecin . Two hundred and twenty-three pupils were r and omly allocated to three test groups : I ( 45 children ) , II ( 71 children ) , III ( 60 children ) and  control group K ( 47 children ) . In both schools mentioned above the examinations started when children were 7 - 8 years old and all of them were receiving planned stomatological treatment and contact fluoridation .  All programs of the second stage of studies were the same as those of the first stage [ 49 ] , only with the modified frequency of meetings with children . Program I , carried out in group I , was based on individual , motivating instructions of oral cavity hygiene ( total 10 meetings during second stage of research ) . Programs II and III ( group II and III accordingly ) were exp and ed by educational activity among children and their parents . Additionally program III was enriched by professional mechanical tooth-cleaning , the use of fissure sealants , intensive dental care and proximal surface cleaning with dental floss ( Tab . 1 ) . The above-mentioned programs were carried out in co-operation with school dentists , teachers , fifth year dentistry students and students from Medical College -- Oral Hygienist Faculty . After 4-years-long studies the evaluation of the three above-mentioned programs in oral cavity hygiene was achieved by using OHI-S and PI(QH ) . The status of periodontium was evaluated by GI and the intensity of dental caries by DMFT and DMFS . The increase of caries during the second stage of examinations was additionally evaluated and analysed thoroughly . The question naire studies made it possible to estimate the changes in the pro-health awareness among examined children . Reduction of OHI-S after 4 years was about 23 % to 26 % ( Fig. 1 ) . The status of gums shows the state of oral cavity hygiene in a better way . In control group the state remained unchanged , but in groups I , II and III it improved considerably ( reduction of GI about 46 % to 79%--Fig . 2 ) . The reduction of caries in examined groups obtained after 4 years of studies was about 25 % to 77 % ( Fig. 3 ) however during the second stage of research if figured out from 17 % up to 72 % ( Fig. 4 ) . Extreme increase of DS observed in the second stage of studies was 2.0 in control group K , a little less--1.51 in group I and 0.38 in group III ( Fig. 5 ) . The DS in group III reached the value -0.27 which proved that program III was the most efficient . The results of question naire studies showed a distinct improvement of health awareness among examined children . However the value of GI indicated some discrepancy between children 's health knowledge and pro-health behaviour . Also it was noticed that the level of parents ' education and their socioeconomic status had influence on building up good hygiene habits and on the state of caries among the examined children . The studies proved that the implementation of the above-mentioned prophylactic-educational programs or similar ones in elementary school conditions is possible with the use of hygienist under the dentist 's supervision OBJECTIVE To assess the impact of regularly supplying free fluoride toothpaste regularly to children , initially aged 12 months , and living in deprived areas of the north west of Engl and on the level of caries in 
    Output:
    
AUTHORS ' CONCLUSIONS Currently , there is insufficient evidence for the efficacy of primary  school-based behavioural interventions for reducing caries .
There is limited evidence for the effectiveness of these interventions on plaque outcomes and on children 's oral health knowledge acquisition .
None of the included interventions were reported as being based on or derived from behavioural theory .