A Program to Improve the Oral Health of School Children in the Kingdom of Tonga:the MaliMali Program

抄録

The South Pacific Medical Team, a voluntary group organized by Japanese dentists, has worked to improve oral health in the Kingdom of Tonga since 1998. Its main activity is the planning and administration of a school-based program known as the MaliMali Program.The MaliMali Program has been promoted by a Tongan team for preventive dentistry from the Dental Office of the Ministry of Health. In the present study, we describe the results of the MaliMali Program and consider its effects from 1998 to 2009.The MaliMali Program consists of the following three main programs, plus additional activities: an education program for kindergarten and primary school children to prevent caries (including leaflet distribution, lectures, and guidance about eating between meals); a program teaching children about the proper use of toothbrushes and fluoride toothpaste;and a program providing children with fluoride mouth rinse. In the latter program, 7-10mL of a 0.2% NaF solution was given to children in primary school once a week; 5mL of a 0.05% NaF solution (Miranol^®) was given to children in kindergarten once a day. We investigated oral health habits (dietary habits in 2001, toothbrushing habits in 2008), oral conditions (prevalence of dental caries in 2001 and 2007, effectiveness of fluoride mouth rinse for prevention of caries in 2008), and gingivitis and gingival bleeding (in 2003). In 2008, 34 kindergartens, 101 primary schools (75.4% of all schools in Tonga), and 14,442 children in total participated in the MaliMali Program. In 2008, all children reported brushing their teeth at least once a day. The mean decayed/missing/filled teeth (DMFT) score DMFT and the decayed/missing/filled (DMF) person rate had decreased significantly in 2007 compared to 2001. In 2008, we examined whether fluoride mouth rinse is effective for the prevention of caries and found that fluoride mouth rinse significantly decreased the mean DMFT score. In 2003, 52.0% of children had gingivitis and 20.6% had gingival bleeding.The MaliMali Program is universally accepted in the Kingdom of Tonga. It has helped to establish childrenʼs toothbrushing habits and the application of fluoride has decreased the incidence of caries.