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Publication Date


Publication Title

Journal of Dental Hygiene








Purpose: Dental caries is a non-communicable, preventable disease that disproportionately affects low-income children in the United States (US). The purpose of this systematic review was to describe oral health education and promotion activities designed to prevent early childhood caries (ECC) provided by Early Head Start (EHS) programs in the United States.

Methods: Five databases were searched including CINAHL, Dentistry & Oral Sciences Source through EBSCO, PubMed, Google Scholar, and the Wiley Online Library, to identify peer-reviewed quantitative studies published in English on oral health education and promotion activities within EHS programs from 2000 to 2019. Studies were assessed for eligibility using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram (PRISMA). Two researchers independently evaluated the included studies.

Results: The initial search yielded a total of 363 articles. Following the screening process, five studies met the inclusion criteria (observational, n=2; quasi-experimental, n=3). The main outcome measures included oral health knowledge, attitudes and behaviors, oral health education, oral health promotion, and oral health activities. Three studies investigated the effectiveness of oral health education and promotion interventions among EHS staff and parents. Two studies examined oral health activities such as education, toothbrushing instructions, toothpaste use, dietary education, and dental assessment.

Conclusion: Studies that focused on increasing pediatric oral health knowledge and practice behaviors among both EHS staff members and parents reflected positive outcomes. Ongoing research is needed to examine the effectiveness of oral health education and promotion activities as they relate to the oral health outcomes of children enrolled in EHS programs.


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Original Publication Citation

Joufi, A. I., Claiborne, D. M., & Shuman, D. S. (2021). Oral health education and promotion activities by early head start programs in the United States: A systematic review. Journal of Dental Hygiene, 95(5), 14-21.


0000-0002-8053-5835 (Joufi), 0000-0001-6324-9856 (Claiborne)