Peer-led oral health education model for elementary school-aged children in British Columbia, Canada.

Objective: To examine the effectiveness of peer-led preventive oral health education for elementary school-aged children. Methods: A controlled, non-randomized interventional study included children in grades 4 to 6 (N = 372) from 6 schools in British Columbia, Canada. The control group (3 schools) received a class-based lecture on oral health. In the intervention group (3 schools), each sixth grader mentored a small group of fourth and fifth graders. The study outcomes were 1) need for oral care referrals (visual screening); 2) oral health knowledge (self-reports); 3) oral self-care practice (OSC-P); and 4) oral self-care skills (OSC-S). Assessments of OSC-P and OSC-S were based on disclosed dental biofilm levels. Study group comparisons were done at baseline and 8 to 12 months. Results: A high need for oral care referrals was found, with a substantial reduction achieved during the study period. Dietary knowledge improved minimally in the intervention group. In both study groups and within age groups, there was a wide variation in OSC-P and OSC-S. Overall, children's OSC-P scores were substantially higher than their OSC-S scores. Oral self-care outcomes improved over time in both groups (except for fourth graders in the control group), with a more substantial improvement in the intervention group. From baseline to study end, the mean OSC-P improved by 11.9% (intervention group) and 5.9% (control group). Improvement values for OSC-S were 12.8% and 5.2%. Conclusions: The need for oral care referrals was reduced, but improvement in oral health knowledge was minimal. Oral self-care outcomes improved more in the intervention than in the control group.