Reassessing project approach of Bocas Sanas Holanda-Maimon (BSHM) after COVID-19 pandemic: what is effective and efficient?

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.