Development of School-based Oral Health Program in Emerging Countries

Abstract

Simplified and Modified Atraumatic Restorative Treatment (SMART) program provides school children the removal of caries lesions with hand instruments and restoration of cavities using encapsulated glass ionomer in communities without access to conventional dental clinics in emerging countries. The purpose of this study was to investigate the effectiveness of SMART program in children to adopt in emerging countries, and to evaluate patients and dentists responses of the SMART program. The author conducted SMART program with 19 Lao dentists in kindergartens in Vientiane, Lao PDR. A total of 368 kindergarten children were provided SMART restoration and evaluated after one year. A questionnaire survey consisted of 8 items was conducted on SMART program to 118 related parents. 19 Lao dentists who practiced SMART program were questioned about opinions and practices of the program. The 1-year survival rate of fully and partially retained SMART were 76.2%. There was no significant difference among age groups of children. The results showed a relatively higher success rate in the posterior teeth than anterior teeth. And it clearly demonstrate that the effectiveness of the SMART program depends on the experience of practitioners. (p<0.01) A total of 98% of Lao parents responded that SMART program was useful and showed positive attitude toward the program. Most of the children did not report discomfort. All 19 Lao dentists responded to participate in the sustainable SMART program. This study showed that it would be recommended that SMART program to prevent and treat dental caries effectively in emerging country.