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Research in Dental Health Education and
Health Promotion: A Review of the Literature
Louise F. Brown, MPH, BDSc, MDSc, PhD
This article presents a review of research in dental health education and health promotion.
In the period 1982 to 1992, a total of 57 studies evaluating the effectiveness of
interventions to alter individuals’ behavior related to dental health were identified. Combining
the results of these 57 studies with descriptive articles published over the same
period, it appears that dental health education can result in improvements in objective
measures of dental health behaviors and actual oral health measures, but has only limited
success in changing attitudes towards dental issues and achieves only short-term gains in
knowledge. The limited use of theoretical frameworks, poor statistical analyses, the use
of convenient samples and the short postintervention follow-up periods diminish the
contribution of this research to the development of dental health policy and the formation
of strategies to improve the health of communities.
INTRODUCTION
Improvements in oral health have been documented in Western countries
over the last 25 years.’-5 National surveys of the prevalence of dental caries
among children in the United States reveal a sharp decline in tooth decay from
1971 to 1987, with a 32% reduction in the mean number of decayed, missing,
and filled permanent tooth surfaces (DMFS index) between 1971 and 1980,’ and
a further reduction of about 36% between 1980 and 1987.2 By 1987, approximately
50% of children aged 5 to 17 years were free of dental decay in the
permanent dentition.2 However, a minority of children still suffered unacceptably
high levels of dental decay.
Improvements in the oral health of adults have also been documented. 4-6 The
loss of teeth, the dental equivalent of a mortality measure, has declined markedly
since World War II.6 However, the retention of teeth into adult years is often
accompanied by significant morbidity due to the breakdown of existing restorations,
active dental caries, and forms of periodontal diseases. Inequalities in
oral health are marked among adults, with people from disadvantaged backgrounds
being significantly more likely to have more untreated dental caries,
Louise F. Brown is with the School of Dental Science, The University of Melbourne,
Parkville, Victoria, Australia.
Address reprint requests to Louise F. Brown, School of Dental Science, the University
of Melbourne, Grattan Street, Parkville, Victoria 3052, Australia.
Health Education Quarterly, Vol. 21(1): 83-102 (Spring 1994)
© 1994 by SOPHE. Publishes by John Wiley & Sons, Inc. CCC 0195-8402/94/010083-20