Impact evaluation of an educational intervention on oral hygiene in vulnerable communities in Somoto, Nicaragua. Results of the O’Leary Index 2023–2024.Impact evaluation of an educational intervention on oral hygiene in vulnerable communities in Somoto, N
DOI:
https://doi.org/10.62407/jjwery30Keywords:
Oral Health, Dental Caries, Dental Plaque Index, Dental Health Education, Vulnerable Populations, Preventive DentistryAbstract
Objective: To evaluate the impact of a multimodal educational and clinical intervention on the O'Leary Index in a cohort of children from vulnerable communities in Somoto, Nicaragua, through a one-year longitudinal follow-up (2023–2024). Methodology: A single-group quasi-experimental study with a pretest-posttest design was conducted. The sample included 51 children selected by convenience who completed the intervention protocol. The normality of the differences was verified using the Shapiro-Wilk test (p: 0.729). Bivariate analysis was performed using Student’s t-test for paired samples. Additionally, McNemar’s test and a post-hoc statistical power analysis were conducted to validate the sample size. Results: A statistically significant decrease was observed in the average O'Leary Index, falling from 50.61% (±21.93) in 2023 to 36.36% (±17.97) in 2024 (Difference: 14.25%; t: 3.341; p: 0.0016). At the individual level, 64.7% of participants significantly improved their oral hygiene (x²: 4.41; p: 0.035). The study achieved a statistical power of 90.6% (d: 0.467), confirming that the sample size was sufficient to detect the program’s positive impact. Conclusions: The intervention carried out by the UAM-INPRHU proved highly effective, resulting in a substantial improvement in the oral health of a vulnerable population. It is concluded that the mobile clinic model is a successful tool for promoting equity; it is recommended that the frequency of these interventions be increased to maximize their impact and ensure the sustainability of the observed hygiene habits.
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Agudelo-Ramírez Alexandra, Galvis-Aricapa Johnny Alexander, Villegas-García Edwin. (2023) Salud bucal en la primera infancia: estrategia con agentes educativas y acudientes. Revista Cuidarte;14(2):e2676. http://dx.doi.org/10.15649/cuidarte.2676
Altamirano, C. M. G., Osorio, Á. A., Palma, A. S. E., Trujillo, M. B., Vásquez Díaz, M. del S., Palacios, A. L. R., Ortega, R. J. D., Rodríguez, B. M. P., & Cáceres, W. M. M. (2024). Sistema de información permanente en salud bucal mediante la integración de la docencia, investigación y extensión. Universitas (León) Revista Científica de la UNAN León, 15(2), 15–20. https://doi.org/10.5377/universitas.v15i2.18846
Álvarez Salcerio, Patricia, De la Hoz Rojas, Liset, Martínez Fernández, Fernando, Pérez De la Hoz, Ana Beatriz, Zayas González, Melba, & López García, Jorge de Jesús. (2022). Intervención educativa sobre salud bucal en niños prescolares. EDUMECENTRO, 14, . Epub 30 de octubre de 2022. Recuperado en 04 de diciembre de 2025, de http://ref.scielo.org/ws2wnm
Arora, A., Nagraj, S. K., Khattri, S., Ismail, N. M., & Eachempati, P. (2022). School dental screening programmes for oral health. Cochrane Library, 2022(7). https://doi.org/10.1002/14651858.cd012595.pub4
Azcarate-Velazquez, F., Garrido-Serrano, R., Castillo-Dali, G., Serrera-Figallo, M., Gañan-Calvo, A., & Torres-Lagares, D. (2017). Effectiveness of flossing loops in the control of the gingival health. Journal of Clinical and Experimental Dentistry, 9(10), e1233–e1238. https://doi.org/10.4317/jced.53858
Bramantoro, T., Santoso, C. M. A., Hariyani, N., Setyowati, D., Zulfiana, A. A., Nor, N. A. M., Nagy, A., Pratamawari, D. N. P., & Irmalia, W. R. (2021). Effectiveness of school-based oral health promotion programmes from preschool to high school: A systematic review. PLoS ONE, 16(8), e0256007. https://doi.org/10.1371/journal.pone.0256007
Cabrera, C., Arancet, M. I., Martínez, D., Cueto, A., & Espinoza, S. (2015). Salud oral en población escolar urbana y rural. International Journal of Odontostomatology, 9(3), 341–348. https://doi.org/10.4067/S0718-381X2015000300001
Chan, A. K. Y., Tsang, Y. C., Jiang, C. M., Leung, K. C. M., Lo, E. C. M., & Chu, C. H. (2023). Diet, nutrition, and oral health in older adults: A review of the literature. Dentistry Journal, 11(9), 222. https://doi.org/10.3390/dj11090222
Chaple Gil, A. M., & Gispert-Abreu, E. de los Ángeles. (2019). “Amar” el índice de O’Leary. Revista Cubana De Estomatología, 56(4), 1–5. Recuperado a partir de https://revestomatologia.sld.cu/index.php/est/article/view/2154
Cianetti, S., Valenti, C., Orso, M., Lomurno, G., Nardone, M., Lomurno, A. P., Pagano, S., & Lombardo, G. (2021). Systematic review of the literature on dental caries and periodontal disease in socio-economically disadvantaged individuals. International Journal of Environmental Research and Public Health, 18(23), 12360. https://doi.org/10.3390/ijerph182312360
Espinoza-Espinoza, G., Pineda, P., Atala-Acevedo, C., Muñoz-Millán, P., Muñoz, S., Weits, A., Hernandez, B., Castillo, J., & Zaror, C. (2021). Prevalencia y severidad de caries dental en los niños beneficiarios del programa de salud oral asociados a escuelas de Chile. International Journal of Odontostomatology, 15(1), 166–174. https://doi.org/10.4067/S0718-381X2021000100166
Gallione, C., Bassi, E., Cattaneo, A., Busca, E., Basso, I., & Molin, A. D. (2025). Oral health care: A systematic review of clinical practice guidelines. Nursing and Health Sciences, 27(1). https://doi.org/10.1111/nhs.70027
García, K. E. M., Cuadra, C. N. C., Rayo, M. E. G., Guevara, G. J. H., & Machado, F. A. R. (2025). Comparación de la tasa de supervivencia de dos cementos de ionómero de vidrio de alta viscosidad en cavidades clase II utilizando la técnica restaurativa atraumática. Revista Odontológica Stomarium, 2(2), 17–38. https://doi.org/10.62407/ros.v2i2.174
González, C. P. (2009). Conocimientos y prácticas de salud bucal en escolares de 8 a 12 años en una comunidad rural de Nicaragua [Tesis de grado]. Universidad Nacional Autónoma de Nicaragua. https://repositorio.unan.edu.ni/7094/1/t606.pdf
Good Neighbors International. (2023). Conducting a health education needs assessment in rural Nicaragua. Health Education Journal, 82(1), 45–59. https://doi.org/10.1177/0017896919896615
Greene, J. C., & Vermillion, J. R. (1964). The Simplified Oral Hygiene Index. Journal of the American Dental Association (1939), 68, 7–13. https://doi.org/10.14219/jada.archive.1964.0034
Haro Sarango, A. F., Chisag Pallmay, E. R., Ruiz Sarzosa, J. P., & Caicedo Pozo, J. E. (2024). Tipos y clasificación de las investigaciones. LATAM Revista Latinoamericana de Ciencias. Sociales y Humanidades 5 (2), 956 – 966. https://doi.org/10.56712/latam.v5i2.1927
Kilian, M., Chapple, I., Hannig, M., et al. (2016). The oral microbiome – an update for oral healthcare professionals. British Dental Journal, 221(10), 657–666. https://doi.org/10.1038/sj.bdj.2016.865
Kim, Y., & Nam, S. (2025). Effectiveness of Glycyrrhiza uralensis extract on periodontal pathogens: A randomized controlled clinical trial. BMC Oral Health, 25(1). https://doi.org/10.1186/s12903-025-06172-2
Liu, Y., Daniel, S. G., Kim, H. E., et al. (2023). Addition of cariogenic pathogens to complex oral microflora drives significant changes in biofilm compositions and functionalities. Microbiome, 11, artículo 123. https://doi.org/10.1186/s40168-023-01561-7
Ministerio de Salud de Nicaragua. (2022). Relación entre el estado de higiene oral y el nivel de conocimiento sobre salud bucal en escolares de zonas rurales. https://www.minsa.gob.ni/sites/default/files/2022-10/Relacion%20entre%20el%20estado%20de%20higiene%20oral%20en%20relación%20al%20nivel%20de%20conocimiento%20sobre%20salud%20bucal.pdf
O’Leary, T. J., Drake, R. B., & Naylor, J. E. (1972). The plaque control record. Journal of Periodontology, 43(1), 38–40. https://doi.org/10.1902/jop.1972.43.1.38
Pawlaczyk-Kamieńska, T., Torlińska-Walkowiak, N., & Borysewicz-Lewicka, M. (2018). The relationship between oral hygiene level and gingivitis in children. Advances in Clinical and Experimental Medicine, 27(10), 1397–1401. https://doi.org/10.17219/acem/70417
Ramírez-Pedraza, A., Salazar-Colores, S., Cárdenas-Valle, C., Terven, J., González-Barbosa, J. J., Ornelas-Rodríguez, F. J., Hurtado-Ramos, J. B., Ramírez-Pedraza, R., Córdova-Esparza, D. M., & Romero-González, J. A. (2025). Deep learning in oral hygiene: Automated dental plaque detection via YOLO frameworks and quantification using the O’Leary Index. Diagnostics, 15(2), 231. https://doi.org/10.3390/diagnostics15020231
Rashid, M. H., Kumar, S. P., Rajan, R., et al. (2025). Salivary microbiota dysbiosis and elevated polyamine levels contribute to the severity of periodontal disease. BMC Oral Health, 25, artículo 2. https://doi.org/10.1186/s12903-024-05381-5
Sánchez, M. M. C., & Sáenz, J. R. V. (2024b). Cambios en conocimientos e higiene bucal tras intervenciones educativas en un centro educativo de Managua, Nicaragua. Universitas Odontológica, 43. https://doi.org/10.11144/javeriana.uo43.ckoh
Silness, J., & Loe, H. (1964). Periodontal Disease In Pregnancy. Ii. Correlation Between Oral Hygiene And Periodontal Condtion. Acta odontologica Scandinavica, 22, 121–135. https://doi.org/10.3109/00016356408993968
Soldani, F. A., Lamont, T., Jones, K., Young, L., Walsh, T., Lala, R., & Clarkson, J. E. (2018). One-to-one oral hygiene advice provided in a dental setting for oral health. Cochrane Library, 2018(10). https://doi.org/10.1002/14651858.cd007447.pub2
Trullàs Arraut, A., Veloso Durán, A., Chung Leng, I., Muñoz Piqueras, L., & Guinot Jimeno, F. (2021). Comparación de la eficacia de tres métodos diferentes de enseñanza de higiene oral en niños españoles de 3 a 5 años de edad. Odontología Pediátrica, 29(3), 117–126. https://dialnet.unirioja.es/servlet/articulo?codigo=8306088
Van Meijeren-Van Lunteren, A., You, Y., Raat, H., Wolvius, E., & Kragt, L. (2022). Caries preventive interventions and oral health inequalities: A scoping review. JDR Clinical & Translational Research, 8(4), 311–325. https://doi.org/10.1177/23800844221109116
Zou, J., Du, Q., Ge, L., Wang, J., Wang, X., Li, Y., Song, G., Zhao, W., Chen, X., Jiang, B., Mei, Y., Huang, Y., Deng, S., Zhang, H., Li, Y., & Zhou, X. (2022). Expert consensus on early childhood caries management. International Journal of Oral Science, 14(1). https://doi.org/10.1038/s41368-022-00186-0
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