A qualitative study of the implementation of a pilot school-based, toothbrushing programme

BackgroundThe aim of the study was to explore stakeholders’ barriers and facilitators to implement a school-based toothbrushing programme.MethodsFocus groups and interviews were used to explore the views of elementary school students, teachers, staff, and nurses in a piloted school-based toothbrushing programme. The topic guides were developed according to the Theoretical Domains Framework (TDF) to cover the behavioural factors systematically and comprehensively. Data were analysed with content analysis.ResultsOverall, 36 students, 29 teachers/staff, and five school nurses (N=65) were included. The main theme was the importance of ‘habit’. The routine and schedule in school helped children establish the toothbrushing habit. However, children did not appear to retain the dental knowledge which was taught in the programme. Instead the key factors in the implementation of the programme were providing fluoride toothpaste and toothbrush for use in schools, allowing teachers and staff to choose the timing of the brushing and engaging classmate to supervise each other is essential.ConclusionsImplementing a school-based toothbrushing programme with the support of staff and engagement of children can h elp children to develop a toothbrushing habit. Further research is needed to explore ways to motivate teachers and staff to fully embrace such a programme. Classmate-supervised toothbrushing may reduce the burden of teachers and staff to implement a school-based toothbrushing programme. This paper also shows that providing suitable fluoride toothpaste rather than dental knowledge may better form children’s brushing habits.