Development of a Community-Based Participatory Oral Health Promotion Model for Preschool Children in Early Childhood Development Centers, Sam Phrao Subdistrict, Udon Thani Province, Thailand

Abstract

Dental caries among preschool children remains a significant public health problem. This study aimed to: (1) examine the oral health status and oral health promotion system in early childhood development centers; (2) develop a community-participatory oral health promotion model for preschool children; and (3) evaluate the effectiveness of the developed model. This research and development (R&D) study was conducted in early childhood development centers in Sam Phrao Subdistrict, Mueang Udon Thani District, Udon Thani Province, Thailand, from May to October 2025. The study comprised four phases: situational analysis, model development, model implementation, and evaluation. The target participants included preschool children, parents or caregivers, childcare teachers, and community stakeholders. Data were collected through oral health examinations, focus group discussions, and questionnaires. Data were analyzed using descriptive and inferential statistics.

Results: Among 93 preschool children who underwent oral health examinations, 17.20% had dental caries, 30.11% had early carious lesions (white spot lesions), and 35.48% had dental plaque. The existing oral health promotion system showed gaps in parental participation, risk-group screening, and information linkage among relevant sectors. Consequently, the researchers developed the 4M–C Model, comprising four components: Motivation (M1), Monitoring and Screening (M2), Maintenance of Oral Health Behaviors (M3), and Management (M4). Community Participation (C) served as the linking mechanism among these components, while Continuous Improvement was incorporated to support ongoing development and refinement of the model.

Among 52 parents or caregivers with complete pre- and post-intervention data, perception scores increased significantly (p < 0.001; effect size r = 0.84–0.90). Knowledge scores increased from 11.04 ± 2.37 to 12.15 ± 1.72 (mean difference = 1.12; 95% CI: 0.61–1.62; p < 0.001). Overall oral health care behavior scores also increased significantly, from 34.60 ± 5.73 to 35.73 ± 5.62 (p = 0.034). In addition, the prevalence of dental plaque among children decreased from 45.60% to 1.50% (p < 0.001), while the prevalence of early carious lesions decreased from 44.10% to 22.10% (p = 0.001). The mean decayed, missing, and filled teeth (dmft) index did not change significantly (p = 0.339).

Conclusions: The 4M–C Model enhanced oral health promotion practices by transforming fragmented activities into a more integrated and coordinated approach. The model improved parents’ or caregivers’ knowledge and oral health care behaviors and was associated with significant reductions in dental plaque and early carious lesions among preschool children. The model may therefore be applicable to other settings with similar contexts.