Assessing the oral health of school-age children and the current school-based dental screening programme in Freiburg (Germany)

Germany has a three-tiered system of education at secondary school level, divided into the school types ‘Hauptschule’, Realschule’ and ‘Gymnasium’. All students receive, when aged 6–12 years, a uniform annual dental examination and oral health education programme. Objectives: The aim of this cross-sectional study was to report on the dental caries levels of school-age children stratified into these three different school types at secondary school level to enable oral healthcare personnel to administer a focused, school-based dental screening and education programme according to patients’ needs rather than a uniform dental examination. Methods: A representative, random sample of 12-year-old school children in Freiburg (Germany) was examined and dental caries was recorded using WHO criteria. Results: A total of 322 12-year-old children participated. The mean DMFT was 0.69. An examination of the distribution of the DMFT score revealed that its distribution is positively skewed. For this reason, this study provides summary analyses based on medians and a non-parametric rank sum test. The non-parametric Kruskal-Wallis H-test showed a highly significant difference between median scores across the different school types (P-value = 0.004). The significance was a result of the ‘Gymnasium’ distribution of DMFT scores which differed markedly from the other two school types. Conclusions: The finding of the present study suggests that it may be useful to stratify the school dental screening and education programme according to school type and to prioritize children who attend ‘Realschule’ and ‘Hauptschule’. This shift should systematically target children with the greatest need for dental care.