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Effect of Oral Health Screening on Dental Caries Detection among Primary School Children in Nigeria

Abstract

Dental caries is one of the most common oral health conditions affecting children and remains an important public health concern in Nigeria. Untreated dental caries can cause toothache, difficulty eating, sleep disturbance, school absenteeism, impaired concentration, and other consequences that may negatively affect children's health and well-being. Early detection provides an opportunity for timely preventive and restorative care and may reduce the progression of dental disease and its associated complications. Oral health screening provides a practical approach for identifying children with suspected dental caries and other oral health problems, particularly when delivered through schools and community-based programmes where children can be reached systematically. However, limited access to dental professionals, inadequate oral health services, low awareness, financial barriers, insufficient screening equipment, and weak referral systems may contribute to delayed detection of dental caries among children in Nigeria. Dental caries detection refers to the identification of children with suspected or confirmed tooth decay through appropriate oral examination and subsequent dental assessment where necessary. Against this background, this study investigates the effect of oral health screening on dental caries detection among primary school children in Nigeria. The study will be anchored on the Health Belief Model, the Health Systems Framework, and the Social Ecological Model. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action and provides a framework for understanding participation in oral health screening. The Health Systems Framework emphasizes service delivery, health workforce, health information, essential technologies, financing, and accessibility as important components of effective oral healthcare delivery. The Social Ecological Model recognizes the influence of individual, family, school, community, and healthcare-system factors on children's health and access to preventive services. Collectively, these theoretical perspectives provide a suitable framework for explaining how oral health screening may influence dental caries detection among primary school children in Nigeria. The study will adopt a quantitative cross-sectional or school-based analytical research design. The study population will comprise primary school children in selected public and private primary schools across Nigeria. A multistage sampling technique will be used to select states, local government areas, schools, classes, and eligible pupils. Oral health screening will be assessed using indicators such as availability and frequency of school-based screening activities, availability of trained dental or oral health personnel, availability of appropriate screening equipment, screening coverage, oral health education, parental notification, screening procedures, documentation of findings, referral arrangements, and follow-up services. Dental caries detection will be assessed using indicators such as completion of oral examination, identification of suspected dental caries, number of affected teeth, identification of untreated carious lesions, referral for comprehensive dental examination, and confirmed diagnosis where appropriate. Data will be collected using structured questionnaires, oral health screening forms, school health records, dental examination records, referral registers, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, and dental caries detection patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of oral health screening on dental caries detection. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that effective oral health screening has a significant positive effect on dental caries detection among primary school children in Nigeria. Children who participate in regular school-based or community-based oral health screening are expected to have a greater likelihood of having previously undetected dental caries identified than children who do not receive screening. School-based screening may improve access to oral health assessment by bringing preventive services directly to children in their learning environment and reducing barriers associated with travelling to dental facilities. Oral health education provided during screening activities may also improve children's and parents' awareness of dental caries and the importance of early dental care. Early identification of dental caries may facilitate timely referral for preventive treatment, restoration, or other appropriate dental services. Conversely, inadequate screening coverage, shortages of trained oral health personnel, limited equipment, low parental awareness, poor referral systems, and financial barriers to follow-up dental treatment may reduce the effectiveness of oral health screening. The study may also demonstrate that screening programmes are most effective when they are linked to accessible diagnostic and treatment services. The study is expected to contribute to the literature on oral health screening, dental caries detection, school health, dental public health, child health, preventive healthcare, epidemiology, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, school administrators, dentists, dental therapists, community health workers, school health programme managers, development partners, and policymakers regarding strategies for improving children's oral health. The study will also provide evidence-based recommendations for expanding school-based oral health screening, strengthening oral health education, increasing the availability of trained dental personnel, improving screening equipment and supplies, strengthening referral and follow-up systems, reducing financial barriers to dental treatment, and integrating oral health screening into routine school health and primary healthcare programmes across Nigeria.

Keywords: Oral health screening, dental caries detection, primary school children, Nigeria, dental caries, school health, dental public health, oral health, early detection, preventive healthcare, child health, epidemiology, public health.