JMIR Publications

ABSTRACT

Background:

Children with disabilities attending special education schools face significantly higher risks of oral diseases, particularly dental caries, due to physiological, cognitive, and environmental challenges. However, school-based oral health interventions targeting this population are limited in China.

Objective:

This study aims to assess the effectiveness of fluoride varnish (FV) application, delivered alongside oral health education for parents and teachers, in improving the oral health of students in special education schools in Guangdong Province.

Methods:

This is a stratified cluster randomized controlled trial conducted in Guangdong Province, China. Schools will be stratified by regional economic development level and randomly assigned to either an intervention or control group. The intervention group will receive annual dental examinations, biannual FV applications, and oral health education. The control group will receive standard annual examinations only. Participants will be students aged 5-22 years enrolled in selected special education schools. Baseline assessments and 12-month follow-up will include oral examinations and questionnaires assessing oral health knowledge, attitudes, and behaviours. The primary outcome is the difference in caries prevalence between the intervention and control groups at follow-up. Secondary outcomes include changes in oral hygiene behaviours and caregiver knowledge. Data will be analysed using multivariable regression models adjusting for potential confounders and clustering effects.

Results:

The study protocol has been approved by the Institutional Review Board of Sun Yat-sen University (2025-065). Informed consent will be obtained from parents or legal guardians of all participants. Findings will be disseminated through peer-reviewed journals, conference presentations, and policy briefs targeting health and education authorities.

Conclusions:

Biannual application of FV is expected to significantly reduce caries prevalence and improve oral hygiene behaviors among students in special education schools. This school-based intervention model aims to provide a scalable and evidence-based strategy to mitigate oral health inequities for children with disabilities in China. Clinical Trial: This trial has been registered at Chinese Clinical Trial Registry (ChiCTR) (ChiCTR2500104919), prior to enrolment of the first participant.