Integrating Oral Health Curriculum into Indian Schools: Evidence-Based Perspectives and Policy Recommendations for National Implementation from a trial in Kerala, India

Integrating Oral Health Curriculum into Indian Schools: Evidence-Based Perspectives and Policy Recommendations for National Implementation from a trial in Kerala, India | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Perspective Integrating Oral Health Curriculum into Indian Schools: Evidence-Based Perspectives and Policy Recommendations for National Implementation from a trial in Kerala, India Hindol Das, Chandrashekar Janakiram This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8186678/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Oral diseases, particularly dental caries, remain a pressing public health challenge in India, affecting a significant proportion of children and contributing to long-term health, social, and economic consequences. Despite numerous health initiatives, structured, evidence-based oral health education is still insufficiently integrated into school curricula, limiting opportunities for early prevention and the development of lifelong healthy behaviors. Drawing on a cluster-randomized trial conducted in Ernakulam district, Kerala and an umbrella review of 27 systematic reviews and, this perspective highlights the effectiveness of a structured oral health curriculum, “Everlasting Smiles.” Delivered over 24 months by both dental professionals and trained schoolteachers, the program significantly improved children’s oral hygiene practices, knowledge, attitudes, and behaviors, while also reducing dental caries increment and plaque and gingival indices, with dentist-led interventions achieving superior outcomes. These findings highlight that school-based oral health education, when delivered consistently and supported by appropriate training, preventive services, and community engagement, can play a transformative role in reducing disease burden and fostering preventive health culture from an early age. Integrating standardized oral health modules into the national curriculum, accompanied by policy support, dedicated funding, and multi-sector collaboration, offers a scalable strategy to equip children with lifelong oral hygiene skills, reduce oral disease prevalence, and contribute to healthier, more informed generations across India. Oral health education Dental caries School-based interventions Curriculum integration Public health policy India Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8186678","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Perspective","associatedPublications":[],"authors":[{"id":549937176,"identity":"a2f248e7-3bea-4f19-b371-8d00beaa9ce5","order_by":0,"name":"Hindol 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