Reassessing project approach of Bocas Sanas Holanda-Maimon (BSHM) after COVID-19 pandemic: what is effective and efficient?
Keywords:
Foundation Bocas Sanas Holanda-Maimón, School-based Oral Health Education and Hygiene program, Promotion of tooth brushing, Dominican Republic
Abstract
This field study was conducted to reassess the DMFT level among 11 to 13-year-old children in five schools in the Dominican Republic. It was also intended to report on the project approach and strategy, including the school-based Oral Health Education and Hygiene program of the Foundation Bocas Sanas Holanda-Maimón (BSHM).
In February, 20-23 and on March, 1, 2023, five primary schools in the province of Puerto Plata were visit, ‘screened’ and re-evaluated by a small BSHM-team of 3 professionals. Of 231 primary school children screened, the DMFT and PUFA levels of 65 11-13 year-old children were measured.
In eight years -compared to measured levels in 2015- the DMFT-level in 11 to 13 year-old children at two of the current selected ‘BSHM-schools’ has significantly increased to DMFT = 4.3 and DMFT = 7.9. In two schools the DMFT-level was both 3.8 and in one school the DMFT = 2.56. Also the PUFA-level were increased, i.e., more pulpal involvement, and fistulas. In general, more caries was seen; in 50%-96% of the screened school children. 104 children were referred to the clinic for professional (caries) treatment.
After COVID-19 pandemic, but also in comparison to the DMFT- and PUFA levels at the beginning of BSHM activities in 2008, the levels in the visited schools have increased and the oral health of school children has deteriorated significantly. Only one school measured healthy teeth and improved oral health.
Knowing that improving the implementation of evidence-based practice and public health depends on behavior change, and based on these results, it is only logical and realistic that a reconsidered approach to BSHM will have to be drawn up after more than 15 years. In any case, a serious adjustment at regional and local level; especially with regard to referrals to government agencies providing medical and dental care.
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References
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22. Ruff, R. R., Monse, B., Duijster, D., Itchon, G. S., Naliponguit, E., & Benzian, H. (2023). Effectiveness of school-based strategies to prevent tooth decay in Filipino children: A cluster-randomized trial. Community Dentistry and Oral Epidemiology, 51(2), 219–227. https://doi.org/10.1111/cdoe.12729
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24. Verlinden, D. A., Reijneveld, S. A., Lanting, C. I., van Wouwe, J. P., & Schuller, A. A. (2019). Socio-economic inequality in oral health in childhood to young adulthood, despite full dental coverage. European Journal of Oral Sciences, 127(3), 248–253. https://doi.org/10.1111/eos.12609
25. Verlinden, D. A., Schuller, A. A., Vermaire, J. H. E., & Reijneveld, S. A. (2024). Referral from well-child care clinics to dental clinics leads to earlier initiation of preventive dental visits: A quasi-experimental study. International Journal of Paediatric Dentistry, 34(2), 190–197. https://doi.org/10.1111/ipd.13124
2. Benzian, H., Garg, R., Monse, B., Stauf, N., & Varenne, B.. Promoting Oral Health through Programs in Middle Childhood and Adolescence. In: Bundy, D.A.P., Silva, Nd., Horton, S., Jamison, D.T., Patton, G.C., editors. Child and Adolescent Health and Development. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov. Chapter 16.
3. Burrekers, S.Y., Doorman-Vasquez, M.C., Faes-Siebgens, M.J.C.M., Pascual, R.A., & Buunk-Werkhoven, Y.A.B. (2020). Self-Perceived Behavior and Process Evaluation of Bocas Sanas Holanda-Maimón (BSHM): From the Past to the Future. Biomedical Journal of Scientific & Technical Research, 26(5), BJSTR. MS.ID.004422.
4. Buunk-Werkhoven, Y.A.B. & Burrekers, S.Y. (2019). Effects and Benefits of a Program to Promote Tooth Brushing Among 12-Year-Old School Children in the Dominican Republic. Advances in Dentistry & Oral Health, 10(5), 555799. DOI: 10.19080/ADOH.2019.10.555799.
5. Buunk-Werkhoven, Y.A.B., & Burrekers, S.Y. (2017) Oral health awareness, promotion of home oral self-care, and professional oral health care among young mothers and their babies: a pilot project. Oral Health and Care, 2(5), 1-4
6. Buunk-Werkhoven, Y.A.B., Burrekers, S.Y., Jongboer, A., Quant, D.F., & van Maanen-Schakel, N,W. (2011b). Determinants of oral hygiene behavior in the Dominican Republic. International Dental Journal, 61, 328-333.
7. Buunk-Werkhoven, Y., Dijkstra-le Clercq, M., Verheggen-Udding, E., de Jong, N., & Spreen, M. (2012). Halitosis and oral health-related quality of life: a case report. International journal of dental hygiene, 10(1), 3–8. https://doi.org/10.1111/j.1601-5037.2011.00512.x
8. Buunk-Werkhoven, Y.A.B., Dijkstra, A., & van der Schans, C.P. (2011a). Determinants of oral hygiene behavior: A study based on the theory of planned behavior. Community Dentistry and Oral Epidemiology, 3, 250-259.
9. Buunk-Werkhoven, Y. A.B., Dijkstra, A., van der Wal, H., Basic, N., Loomans, S. A., van der Schans, C. P., & van der Meer, R. (2009). Promoting oral hygiene behavior in recruits in the Dutch Army. Military Medicine, 174(9), 971–976. https://doi.org/10.7205/milmed-d-05-0408
10. Buunk-Werkhoven, Y.A.B., Gortzak, J.J.C., Sjoerts, J.E., & Frederiks, A. (2021). ‘Outspoken’ Oral Hygienists Promote Oral Health Care Awareness at Public Events for (Pregnant) Women and Young Mothers. Journal of Dental Hygiene Science, 21, 140-9. https://doi.org/10.17135/ jdhs.2021.21.3.10
11. Buunk-Werkhoven, Y.A.B., & Reyerse, E. (2020). What is the impact of oral (public) health promotion, and of interventions for oral (self) care awareness raising and behavior change? Journal of Dentistry, Oral Disorders & Therapy, 8, 1-4.
12. Buunk-Werkhoven, Y.A.B., Takrovskaja, K., & Steverink-Jorna, L.M. (2018). Kidsfabriek, Oral health awareness and promotion of oral self-care during a learning and play event for children and parents in The Netherlands. Annual Clinical Journal of Dental Health, 7, 22-25.
13. Davidson, K.W., & Scholz, U. (2020). Understanding and predicting health behaviour change: a contemporary view through the lenses of meta-reviews. Health Psychology Review, 14(1),1-5.
doi:10.1080/17437199.2020.1719368
14. GBD 2017 Oral Disorders Collaborators, Bernabe, E., Marcenes, W., Hernandez, C. R., Bailey, J., Abreu, L. G., Alipour, V., Amini, S., Arabloo, J., Arefi, Z., Arora, A., Ayanore, M. A., Bärnighausen, T. W., Bijani, A., Cho, D. Y., Chu, D. T., Crowe, C. S., Demoz, G. T., Demsie, D. G., Dibaji Forooshani, Z. S., … Kassebaum, N. J. (2020). Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study. Journal of Dental Research, 99(4), 362–373. https://doi.org/10.1177/0022034520908533
15. Ghaffari, M., Rakhshanderou, S., Ramezankhani, A., Buunk-Werkhoven, Y., Noroozi, M., & Armoon, B. (2018). Are educating and promoting interventions effective in oral health?: A systematic review. International Journal of Dental Hygiene, 16(1), 48–58. https://doi.org/10.1111/idh.12305
16. Leghrouz, L., Khole, M.R., Splieth, C.H., & Schmoeckel, J. (2024). Tooth Brushing Learning Methods: Differential or Conventional? A Randomized Controlled Clinical Trial. Caries research, 10.1159/000538226. Advance online publication.
17. Nalli, S., Bindiganavale, S.R., & Chowdary, B.U.K. (2016). A study of oral health promotion activities in India. International Journal of Community Medicine and Public Health, 3(8), 2270-2274.
18. Nawang Palupi Pratamawari, D., Ansya Balgies, G., Buunk-Werkhoven, Y.A.B. (2022). How Effective Is Toothbrush Education through Environmental Changes in Elementary School Children. Journal of Dental Hygiene Science, 22, 30-6. https://doi.org/10.17135/jdhs.2022.22.1.30
19. Peres, M. A., Macpherson, L. M. D., Weyant, R. J., Daly, B., Venturelli, R., Mathur, M. R., Listl, S., Celeste, R. K., Guarnizo-Herreño, C. C., Kearns, C., Benzian, H., Allison, P., & Watt, R. G. (2019). Oral diseases: a global public health challenge. Lancet (London, England), 394(10194), 249–260.
https://doi.org/10.1016/S0140-6736(19)31146-8
20. Petersen, P. E. (2010). Improvement of global oral health--the leadership role of the World Health Organization. Community Dental Health, 27(4), 194–198.
21. Petersen P. E. (2003). The World Oral Health Report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme. Community dentistry and oral epidemiology, 31 Suppl 1, 3–23. https://doi.org/10.1046/j..2003.com122.x
22. Ruff, R. R., Monse, B., Duijster, D., Itchon, G. S., Naliponguit, E., & Benzian, H. (2023). Effectiveness of school-based strategies to prevent tooth decay in Filipino children: A cluster-randomized trial. Community Dentistry and Oral Epidemiology, 51(2), 219–227. https://doi.org/10.1111/cdoe.12729
23. Seymour, B., James, Z., Shroff Karhade, D., Barrow, J., Pruneddu, A., Anderson, N. K., Mossey, P., & Definition Of Global Health, T. F. F. T. (2020). A definition of global oral health: An expert consensus approach by the Consortium of Universities for Global Health's Global Oral Health Interest Group. Global Health Action, 13(1), 1814001. https://doi.org/10.1080/16549716.2020.1814001
24. Verlinden, D. A., Reijneveld, S. A., Lanting, C. I., van Wouwe, J. P., & Schuller, A. A. (2019). Socio-economic inequality in oral health in childhood to young adulthood, despite full dental coverage. European Journal of Oral Sciences, 127(3), 248–253. https://doi.org/10.1111/eos.12609
25. Verlinden, D. A., Schuller, A. A., Vermaire, J. H. E., & Reijneveld, S. A. (2024). Referral from well-child care clinics to dental clinics leads to earlier initiation of preventive dental visits: A quasi-experimental study. International Journal of Paediatric Dentistry, 34(2), 190–197. https://doi.org/10.1111/ipd.13124
Published
2025-04-30
How to Cite
A.B. Buunk-Werkhoven, Y., Rypma-Huitema, A., Rypma, W., M. Doorman-Vasquez, C., & Y. Burrekers, S. (2025). Reassessing project approach of Bocas Sanas Holanda-Maimon (BSHM) after COVID-19 pandemic: what is effective and efficient?. Health, Environment and Sustainable Development: Interdisciplinary Approach, (1), 31-38. https://doi.org/10.59476/hesdia.v0i1.693
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Articles
