Effectiveness of School Oral Health Screening and Factors Affecting Dental Attendance Among Female Primary School Children in Saudi Arabia

Objectives: School dental screening and referral is a dental public health measure that helps children with oral health problems to come in contact with dental services. Recent studies have failed to demonstrate the effectiveness of school screening programs in stimulating dental attendance. The objective of the present study is to assess the effectiveness of school oral health screening in stimulating dental attendance and factors affecting dental attendance among female primary school children in Saudi Arabia. Methodology: A multistage cluster random sampling method was used in which the unit of randomization was the school. All children were given comprehensive oral health education followed by oral screening. Oral health referrals to visit dental clinic were given to children needing any dental treatment. The parents were contacted by telephone two months after oral health referral and information on child's dental attendance and reasons for failing to attend dental clinics was collected according to predetermined set of questions and the data was subjected to statistical analysis. Results: A total of 1,035 female school children aged 6 to 12 years received oral health education at school followed by dental screening. Only 211 (23.8%) children attended dental clinics after receiving oral health referrals. The most important reason for not attending the dental clinic was difficulty for working parents to take time off (41.2%) followed by logistic problems (20.4%) and some parents thought dental treatment was not important since there was no pain (9.7%). The least perceived barriers were cost of dental treatment (3.6%), difficulty in taking leave from school (3%), and school exams (3%). Conclusions: School oral health screening and referrals have been found to be ineffective at stimulating dental attendance. Parental factors like 'lack of time' and 'logistic problems' for taking their child to the dentist were found to be major factors affecting dental attendance. Methods to improve parent's awareness regarding oral health of children and alternative choices to ensure adequate dental care to vulnerable children needs to be explored.