Oral health in an urban slum, Nigeria: residents' perceptions, practices and care-seeking experiences.

BACKGROUND/INTRODUCTION: One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions. OBJECTIVES: This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria. METHOD: Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis. RESULTS: Six FGD sessions, divided by gender and age, were conducted between September-October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, "epa Ijebu" (a dentrifice), and "orin ata" (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes. CONCLUSION: The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self-care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people's education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities.

Differences in adoption of COVID-19 pandemic related preventive behaviour by viral load suppression status among people living with HIV during the first wave of the pandemic.

BACKGROUND: Adherence to antiretroviral therapy and COVID-19 preventive behaviours among people living with HIV during the pandemic has received little attention in the literature. To address this gap in knowledge, the present study assessed the associations between viral load, adherence to antiretroviral therapy and the use of COVID-19 prevention strategies during the first wave of the COVID-19 pandemic. This was a secondary analysis of data generated through an online survey recruiting participants from 152 countries. Complete data from 680 respondents living with HIV were extracted for this analysis. RESULTS: The findings suggest that detectable viral load was associated with lower odds of wearing facemasks (AOR: 0.44; 95% CI:0.28-0.69; p < 0.01) and washing hands as often as recommended (AOR: 0.64; 95% CI: 0.42-0.97; p = 0.03). Also, adherence to the use of antiretroviral drugs was associated with lower odds of working remotely (AOR: 0.60; 95% CI: 0.38-0.94; p = 0.02). We found a complex relationship between HIV positive status biological parameters and adherence to COVID-19 preventive measures that may be partly explained by risk-taking behaviours. Further studies are needed to understand the reasons for the study findings.

Factors associated with an increase in tobacco use and alcohol drinking during the COVID-19 pandemic: A cross-sectional study of data from 105 countries.

INTRODUCTION: The COVID-19 pandemic has inevitably led to monumental challenges, and alcohol drinking and tobacco use have unlikely been spared. This cross-sectional survey reports on factors associated with an increase in alcohol drinking and tobacco use during the COVID-19 pandemic. METHODS: An online survey conducted in 2020, generated data from 14899 adults residing in 105 countries. Dependent variables were changes in alcohol drinking and tobacco use. Independent variables were age, sex, education level, job loss, lost or reduced wages, investment/retirement benefits, interrupted substance addiction care, and income level of the countries. Multilevel logistic regression analysis was computed to explore the associations between dependent and independent variables in adjusted models using the backward stepwise method. The probability of including or excluding a covariate was set at p(in)<0.05 and p(out)>0.1, respectively. RESULTS: Of the regular alcohol consumers (N=4401), 22.9% reported an increase in their alcohol drinking. Of the regular tobacco users (N=2718), 31% reported an increase in their tobacco use. Job loss (Alcohol: AOR=1.26; Tobacco: AOR=1.32) and lost/reduced wages (Alcohol: AOR=1.52; Tobacco: AOR=1.52) were associated with higher odds of increased alcohol drinking and tobacco use. Many interruptions to addiction care (AOR=1.75) were associated with higher odds of increased alcohol drinking. Whereas no interruption to addiction care was associated with lower odds of increased alcohol drinking (AOR=0.77). Also, none (AOR=0.66) or some (AOR=0.70) interruptions to addiction care were associated with lower odds of increased tobacco use. CONCLUSIONS: This global survey alludes to the unintended consequences of the current COVID-19 pandemic on alcohol drinking and tobacco use. It is critical that the strategies for emergency responses should include support to ameliorate the impact of financial distress and disruption in substance dependence treatment services.

Tooth adornment among siblings living in an urban slum in Nigeria: Health implications for a vulnerable population.

Tooth jewelry boosts the appearance and confidence of wearers. However, its use may carry adverse health consequences. This paper creates awareness about a practice not previously reported in Nigeria, to prevent negative health consequences while appropriate measures are taken to quantify and describe the determinants and plan appropriate interventions.

APPLICABILITY of DENTAL PATIENT REPORTED OUTCOMES in LOW RESOURCE SETTINGS -A CALL to BRIDGE the GAP in CLINICAL and COMMUNITY DENTISTRY.

Low resource settings (LRSs) are typically regions where inadequate healthcare resources exist and the healthcare system does not meet the acceptable global standards. The problems encountered in LRS in oral and dental medicine could be related to lack of human personnel, e.g., insufficient numbers of dentists and other dental professionals, poor infrastructure, limited or remote treatment/care facilities, lack of dental materials and supplies as well as inadequate monitoring and evaluation of public health programs. Despite the limited human resources in LRS, such settings are currently experiencing a brain drain, a situation where there is massive emigration of highly trained and qualified healthcare professionals including dentists to other countries for better living conditions. To allocate health resources judiciously, exploration of alternatives to traditional oral health assessments, which are cheap, easily available, and patient-oriented, becomes pertinent. Thus, there is a need to consider the applicability of oral assessment tools such as dental patient-reported outcomes (dPROs) in general, and oral health-related quality of life (OHRQoL) in particular. Therefore, the aim of this narrative review was to describe opportunities for the applicability of dPROs in LRSs with a focus on Nigeria, based on empirical data. The applicability of dPROs and OHRQoL in LRS includes prevention, screening, diagnosis, assessment of oral health impact, application of the first step of targeted treatment, treatment evaluation, planning, and monitoring of public health programs, as well as research needs. dPROs could be very useful in LRS because their practical advantages may be utilized to improve patient and population health.

Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.

OBJECTIVES: To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. METHODS: An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. RESULTS: Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). CONCLUSION: According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.

Self-reported and clinically evident gingival bleeding and impact on oral health-related quality of life in young adolescents: a comparative study.

Background: Very little is known about how self-reported gingival bleeding affects the oral health-related quality of life in adolescents compared with clinically evident bleeding. This study aimed to compare the impact of self-reported gingival bleeding and clinically evident gingival bleeding on the oral health-related quality of life in young adolescents. Methods: This was a cross-sectional study involving 976 students (aged 10-14 years) in randomly selected primary schools in Ibadan. Data were obtained by oral examination and completion of the Child Oral Impact on Daily Performance Questionnaire. Data were analysed with SPSS version 24. The Mann Whitney U test was used to determine the association between gingival bleeding and the quality of life. Results: The mean age of the participants was 11.4±1.3 years. Almost half (48.3%) of the participants reported gingival bleeding during tooth cleaning while the gingiva of 534 (54.7%) participants bled on examination. Pupils with self-reported bleeding suffered a significantly greater impact on their overall quality of life than those without self-reported bleeding (mean ranks: 528.1 vs. 451.6, P<0.001). For pupils with self-reported bleeding, there were higher impacts on all domains relating to quality of life than those who did not report bleeding (eating: mean ranks=521.0 vs. 458.2; speaking: 502.2 vs. 475.8; teeth cleaning: 522.7 vs. 456.7; sleeping: 497.7 vs. 456.7; showing teeth/smiling: 503.4 vs. 474.6; emotional stability: 501.1 vs. 476.8; school work: 492.4 vs. 484.9, and enjoying contact with other children: 494.0 vs. 483.4). There was no statistically significant association between clinically evident bleeding and impacts on the quality of life (P=0.272). Conclusion: Almost half of the students reported gingival bleeding while cleaning their teeth and over 50% experienced gingival bleeding on probing. Those with self-reporting of gingival bleeding had greater impacts on oral health-related quality of life compared with those with clinically evident bleeding.

Pediatric patients' reasons for visiting dentists in all WHO regions.

BACKGROUND: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. METHODS: Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients' oral health problems and prevention needs were computed. FINDINGS: Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. CONCLUSIONS: The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.

Why Patients Visit Dentists - A Study in all World Health Organization Regions.

OBJECTIVE: The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. METHODS: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. RESULTS: For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. CONCLUSION: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.

Knowledge of School-Going Adolescents About the Oral Effects of Tobacco Usage in Ibadan, Southwest Nigeria.

BACKGROUND: The individual knowledge of the effects of tobacco usage on health plays an important role in its uptake. Tobacco consumption usually starts during adolescence, and lack of knowledge about the oral problems of tobacco usage probably plays a role in it. AIM: To determine the knowledge of adolescents about the effect of tobacco usage on oral health. METHODS: A cross-sectional study was conducted among 1,465 adolescents aged 12 to 20 years who attended senior secondary schools in a major city in Nigeria. Data were obtained through a semistructured questionnaire. Data obtained were analyzed with SPSS. RESULTS: The mean age of respondents was 15.2 (±1.4) years. Only 40 (2.7%) of them used tobacco at the time of study and 992 (67.7%) said that tobacco usage has effect(s) on oral health. The main effects mentioned were mouth odor: 338 (34.1%); teeth discoloration: 297 (29.9%); tooth decay: 138 (13.9%); damage to teeth: 72 (7.3%); lip discoloration: 39 (3.9%); and oral cancer: 11 (1.1%). It was found that female respondents (72.1%, odds ratio = 1.4, confidence interval = 1.1-1.7, p = .005); those aged 12 to 15 years (73.6%, odds ratio = 2.0, confidence interval = 1.6-2.5, p < .001); and children of skilled workers (73.4%, odds ratio = 1.9, confidence interval = 1.2-3.0, p = .008) were more likely to mention that tobacco has adverse effect(s) on oral health. CONCLUSION: Although two thirds of the students knew that tobacco usage has effects on oral health, there were gross inadequacies in the knowledge and misconceptions about those effects.

Making a Case for Formal School-Based Oral Health Promotion: Oral Health Knowledge, Attitude and Practices of Pupils in Ibadan, Nigeria.

Background Providing evidence for institution of school-based oral health promotion programs is paramount in developing countries, due to increasing unmet dental needs impacting on quality of life of children. Aim To evaluate oral health knowledge, attitude and practices (KAP) of pupils in a country lacking formal school oral health promotion. Methods A cross-sectional study was conducted among 1,297 pupils in randomly selected primary schools in one city. Information on oral health KAP were obtained using interviewer-administered questionnaire. Responses to questions were graded, standardized, and data analyzed using SPSS. Results The mean age was 10.6 (±1.7) years. Mean KAP percentage scores were 18.1 (±5.0)%, 18.3 (±4.9)%, and 17.3 (±12.8)%, respectively. Older age, male gender, and previous dental consultations were significantly associated with higher KAP scores. Those who had been educated informally about oral health had higher mean KAP scores ( p = .013, p < .001, and p < .001, respectively). Previous oral health education and consultation with dentists were significant predictors of higher oral health practice scores. Conclusion Poor oral health KAP exists among the pupils. Those who had consulted the dentist or had oral health education had better KAP. These findings reinforce the need for formal school-based oral health promotion.

Non-clinical factors and predictors of self-rating of oral health among young adolescents in a rural Nigerian population

Aim: The aim of the study was to assess the non-clinical determinants and predictors of self-ratings of oral health among young adolescents in a Nigerian rural population. Methods: A cross-sectional survey was conducted among adolescents of 11-13 years old in Igboora, Nigeria. Information on self-rating of oral health, self-assessed satisfaction with oral health condition and tooth appearance, pain history, consultation with the dentist and oral hygiene measures were obtained using structured questionnaires translated to the local language. Data were analysed using SPSS version 23; Chi Square and logistic regression were used to establish associations between variables and predictors with p value < 0.05 statistically significant. Results: A total of 400 respondents participated in the study. Most 346 (86.5%) rated their oral health positively. Those who expressed dissatisfaction with the appearance of their teeth, 17 (44.7%) dissatisfaction with their oral health condition, 25 (45.5%) had toothache in the preceding six months, 44 (19.7%) perceived a need for dental treatment, 43 (16.7%) or cleaned their teeth once daily or less frequently, 37 (20.9%), rated their oral health poorly (p < 0.001, p < 0.001, p = 0.001, p = 0.012, p < 0.001, respectively). The significant predictors of self-ratings of oral health were self-assessed satisfaction with oral health condition, toothache in the preceding six months and frequency of tooth cleaning. Conclusion: Satisfaction with oral health condition, toothache in the preceding six months and frequency of tooth cleaning are factors that predict self-rating of oral health in young adolescents in the rural community studied

A short report on tooth replacement in an older suburban population in Nigeria.

OBJECTIVES: To determine: the knowledge of the participants about removable dentures, importance of tooth replacement; prevalence of tooth loss and denture use; and factors associated with its non-use among an elderly population in Nigeria. BACKGROUND: Tooth loss without replacement can impact negatively on the quality of life of the elders, thus making use of denture a basic requirement for those with partial or complete edentulous arches in developed countries. It is, however, not known if this is the case among elders in suburban Nigeria. MATERIAL AND METHODS: A cross-section of 392 consenting elderly participants aged ≥65 years residing at Idikan, Ibadan, Nigeria, were interviewed on their biodata, knowledge of removable denture and importance of tooth replacement, history of use of denture and reasons for non-use where applicable. Oral examinations for the presence of missing teeth and denture were conducted by an examiner. Data were analysed with SPSS and P value set at ˂.05. RESULTS: The mean age of the participants was 73 (SD = 9.2) years. About 39% of the participants believed that it was important to replace missing teeth, 56.0% had poor knowledge about tooth replacement options, and 47.7% had at least a missing tooth. Only 7.1% of those with missing teeth had them replaced and all were using removable acrylic partial dentures. Financial constraint was the main reason for non-replacement of missing teeth (80.1%). Age, gender, occupation before retirement, income, level of education and presence of physical impairment were associated with non-use of denture (P Ë‚ .05). CONCLUSION: Many elderly individuals had poor knowledge about removable dentures and the importance of tooth replacement. About half of the participants had full complement of teeth and only 7.1% of those with tooth loss reported denture wear. Major reasons for non-use of dentures were due to economic reasons.

Impact of Oral Health on The Quality of Life of Elementary School Teachers.

BACKGROUND: The success of preventive school health programs is largely dependent on teachers who are role models to pupils and pivotal to implementation. It is therefore important to understand the perception of school teachers about the impact of oral health on their daily activities. The aim of this study was to assess oral health related quality of life of elementary school teachers by evaluating the impact of oral conditions like dental caries and periodontal disease on their daily performances and school work. METHODS: This was a descriptive cross sectional study in which 407 teachers were selected through multistage random sampling technique. Data were collected with structured interviewer-administered Oral Impact on Daily Performances (OIDP) questionnaires and by clinical oral examinations. Data were collated and analysed with SPSS. RESULTS: The prevalence of reporting of impacts on daily performances was 39.1% with eating and enjoying food being the most commonly impacted activity. Impacts on daily performances were more likely to be reported by teachers with better education (p = 0.019). Teachers with caries had higher odds of reporting impacts as a result of oral health status (CI: 1.04, 5.64, p = 0.040). The severity of periodontal disease found on clinical examination was not related to reporting of impacts on quality of life (p > 0.05). CONCLUSIONS: The oral health status of school teachers impacted significantly on their daily performance and school work when they experienced pain. Painless but highly prevalent oral lesions were, however, not perceived to influence their quality of life.

Global self-rating of oral health as summary tool for oral health evaluation in low-resource settings.

OBJECTIVES: Global Self-Rating of Oral Health (GSROH) has numerous benefits, especially in resource-constrained environments with a paucity of dentists thereby potentially limiting administration of oral health surveys and monitoring of dental treatment. The aim of the study was to identify factors that could influence or predict poor self-ratings of oral health. MATERIALS AND METHODS: The study was descriptive in design. Data were collected using structured interviewer-administered questionnaire, which had items on socio-demographic characteristics of the respondents and their GSROH. Oral examination was conducted to identify untreated dental caries, missing teeth, and mobile teeth. Data were analyzed using SPSS, and the P value was set at 0.05. RESULTS: There were 600 participants; 400 were teachers constituting the non-patient population and 200 were dental patients with age ranging from 18 to 83 years. A total of 169 (28.1%) participants rated their oral health as poor, including 104 patients (52.0%) and 65 (16.2%) non-patients (P < 0.001). Having had toothache in the preceding 6 months (62.4% vs. 16.0%, P < 0.001), mobile teeth (46.7% vs. 24.2%, P < 0.001), decayed teeth (49.0% vs. 21.3%, P < 0.001), missing teeth (35.0% vs. 26.1%, P = 0.042), or DMFT score greater than zero (41.1% vs. 20.7%, P < 0.001) was associated with poor GSROH. Presence of mobile teeth [odds ratio (OR) = 2.68; 95% confidence interval (CI): 1.29, 4.23; P < 0.001] and carious teeth (OR = 2.25; 95% CI: 1.09, 4.65; P = 0.029) were independent predictors of GSROH. CONCLUSION: The GSROH was able to identify individuals with or without oral conditions in the studied population, and thus may be used in oral health surveys to assess the oral health status and in monitoring of treatment outcome.

Comparison of two oral health-related quality of life measures among adult dental patients.

PURPOSE: The most commonly used oral health related quality of life measures, Oral Health Impact Profile (OHIP) and Oral Impact on Daily Performances (OIDP), are affected by cultural and linguistic factors, which may be intensified in a treatment-need driven society. This study therefore aimed to compare the psychometric properties of the OHIP-14 and OIDP measures in adult patients in Nigeria where patients typically visit the dentist when dental problems arise. MATERIALS AND METHODS: This was a cross-sectional study in which 264 patients attending two dental clinics were recruited. Data were collected with OHIP-14 and OIDP structured interviewer-administered questionnaires, global self-report and perceived need for dental treatment questions and by oral examination. Data collected were subjected to statistical analysis using SPSS version 19 and the level of statistical significance was set at a p-value of 0.05. RESULTS: The majority (61.0%) rated their oral health status poorly and 203 (76.9%) perceived a need for treatment. The average OHIP and OIDP scores were 12.0 (range 0 to 56) and 8.9 (range 0 to 40), respectively. Both instruments showed a high index of validity and reliability; both had similar face and content validity, however, OIDP had better criterion validity while OHIP-14 had better construct validity and internal consistency. CONCLUSIONS: Both OHIP-14 and OIDP are precise, valid and reliable for evaluation of OHRQOL where dental care is treatment-need driven. They are able to discriminate between groups according to their perception of oral health status, but with OIDP detecting fewer impacts on daily activities.

An audit of school oral health education program in a developing country.

OBJECTIVE: The increasing prevalence of oral diseases in children in developing countries is a major public health concern and creates the need to review various preventive strategies put in place on oral health promotion. In the absence of formal national programs, tertiary health institutions have adopted low-budget school oral education programs targeted at improving oral health awareness and behavioral changes in school children. The aim of this study was to review the school oral health education programs conducted by the Community Dentistry Unit of a tertiary hospital in a major city in Nigeria. MATERIALS AND METHODS: An evaluation of the school oral health education programs conducted in the city over a 5-year period was done. Data collected included: venue of the program, the number of students and teachers educated in each school, screening and referrals, adequacy of teaching aids, desire for revisit, and barriers noted in its conduct. RESULTS: A total of 104 oral health education programs were conducted during this period involving 16,248 participants. The majority (80%) of the schools visited were primary schools and 54% were privately owned. Over half of the programs was conducted on assembly grounds, 21% in classrooms, and 13% in school halls. Challenges encountered included: lack of audiovisual aids, transportation problems, inadequacy of screening tools, and insufficient promotional materials. All the schools visited requested for (subsequent) regular visitation. CONCLUSION: The study showed the feasibility of low-budget oral health education and willingness of schools to benefit from such programs. There are barriers to effective communication, which can be mitigated in order to achieve an optimal school oral health education program in a low resource setting.