Oral health in global school health curriculum – scoping review

Abstract

Background

Dental caries remains the most prevalent chronic disease of childhood, with substantial consequences for children’s health, development, and educational outcomes. Schools provide a strategic platform for oral health promotion, particularly through structured curricula aligned with the World Health Organization’s Health Promoting Schools framework. However, clarity regarding the nature, scope, and implementation of oral health curricula within school settings remains limited. This scoping review aimed to map global evidence on school-based oral health curricula, examining their characteristics, delivery methods, stakeholder involvement, and assessment approaches.

Method

This review followed JBI Methodology for scoping reviews and PRISMA-ScR guidelines. Databases searched were Medline (Ovid), Cochrane Library, SCOPUS, CINAHL (Ovid), Dental & Oral Sciences source (Ovid), Web of Science, grey literature (like ProQuest, Google Scholar), ERIC, Epistemonikos, and government and professional dental associations’ websites. Covidence software facilitated identification and screening of documents containing information about oral health in school curriculum.

Results

From 5,035 records identified, 42 documents met the inclusion criteria. The included evidence was heterogeneous comprising peer-reviewed studies, curriculum documents, websites, dissertations, conference proceedings, and media reports, with most published after 2000. The United States (n = 15) contributed the largest share of evidence, followed by India (n = 7) and United Kingdom (n = 6). Oral health curricula predominantly targeted primary school children focusing mainly on preventive topics such as oral hygiene practices, diet, and regular dental check-ups. Integrated curricula (n = 11)were reported more than stand-alone models (n = 1). Teachers were primary curriculum facilitators(n = 13). Only a minority of documents reported formal assessment methods, most commonly measuring changes in oral health knowledge and attitudes.

Conclusion

Despite the high global burden of childhood oral diseases, evidence on structured school-based oral health curricula remains sparse and heterogeneous. Variability in terminology, curriculum design, delivery, and assessment highlights the need for standardized frameworks and clearer conceptualization of oral health curricula within school health programs. Strengthening and systematically integrating oral health into school curricula has the potential to support sustainable improvements in children’s oral health and overall well-being.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07219-1.

Background

Dental diseases, particularly dental caries, are highly prevalent among children and result in the loss of approximately 50 million school hours annually [1, 2]. Untreated dental caries in primary teeth is the most common childhood disease, affecting an estimated 514 million children worldwide [3]. These unmet oral health needs can compromise a child's physical and mental well-being by adversely impacting their diet, growth, functional abilities, facial harmony, and aesthetics [4]. Addressing this substantial disease burden requires implementation of effective preventive strategies, particularly in school settings.

Given the magnitude of oral disease burden, schools represent an ideal platform for oral health promotion initiatives, because they influence the critical developmental stages during which lifelong oral health-related behaviors, beliefs, and attitudes are established. Health-related practices like tooth brushing and regular dental check-ups are shaped by beliefs, attitudes, and social observation, making school-aged children the ideal target population for fostering healthy habits and modifying existing oral health beliefs. Besides benefitting over one billion children globally, these school-based efforts create a ‘ripple effect’ by extending health-related awareness to teachers, staff, and families [2, 5]. In recognition of this potential, the World Health Organization (WHO) introduced the concept of Health Promoting Schools (HPS) [6, 7].

The HPS framework defines a health promoting school as ‘ a school constantly strengthening its capacity as a healthy setting for living, learning and working [8]. This holistic approach aims to improve the health of school-aged children and adolescents through health-centred school policies, nurturing environments, and community participation [8, 9]. Health education is a core component of the HPS framework and is typically delivered through a curriculum format. A curriculum is “a planned educational experience which encompasses one or more sessions on a specific subject to an entire training program” [10].

Curriculum can be designed in an integrated or stand-alone format. Integrated or interdisciplinary curricula incorporate health education into other subjects like mathematics and physical education [11],while a stand-alone curricula deliver health education as a distinct subject [12]. The integrated curricula help address time constraints that are frequently encountered in school settings [13]. It enhance the students’ critical thinking while providing engaging learning experiences [13–15]. An example is “PowerUp!” which is an integrated curriculum developed to prevent chronic disease by incorporating lessons on healthy food choices into core subjects taught by schoolteachers [13]. “Explore. Define. Measure: An Integrated Curriculum for the Elementary Classroom” developed by the Asthma 411 Initiative, enables schoolchildren to learn about asthma through science, arts, and mathematics classes. This approach promotes awareness about common childhood health issues without specifically targeting asthmatic students thereby minimizing potential discriminatory or embarrassing situations [16].

Similarly, to resolve the growing burden of oral diseases among children, oral health can be taught as an integrated or stand-alone subject within school curricula [17]. Such approaches have the potential to promote good oral hygiene practices and healthy lifestyle choices from an early age. However, despite the progress of the HPS framework in fostering health-centred learning ecosystem in schools, evidence regarding the systematic inclusion of oral health within school curricula remains limited. This calls for a focused approach because clarity and consistency regarding the inclusion of oral health in school curricula are still lacking.

The absence of detailed studies, standardized frameworks, and consistent terminology regarding what constitutes a ‘curriculum’ emphasize the need for a scoping review. This gap is further aggravated by the scarcity of comprehensive literature describing curriculum content, delivery methods, and assessment approaches. These limitations of existing evidence adversely impact the identification of best practices. This scoping review was conducted to address these limitations by mapping the existing evidence on school-based oral health curricula globally, clarify conceptual and practical limitations, and inform the integration of oral health into school health curricula.

Method

This scoping review was conducted on the basis of JBI methodology for scoping review [18] and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping review (PRISMA-ScR) [19]. This review is registered with Open Science Framework (https://osf.io/7dr6t/). Following steps were undertaken to conduct the scoping review:

Stage 1—Identifying the research question

The primary review question was “What are the different health curriculums available for oral health for schoolchildren globally?”. Following were the sub-questions:

1. What are the types of school health curriculum (integrated or stand-alone) that include oral health?

2. What educational methodologies were followed in these curricula?

3. What is the existing evidence regarding school oral health curriculum assessments?

Stage 2—identifying relevant studies

The Population, Concept, Context (PCC) format was used for aligning the study selection with the research question (Supplementary Table 1. PCC framework used to define eligibility criteria).

Population (P) – Schoolchildren.

This scoping review included only those studies that focus on schoolchildren irrespective of their age, gender, or health status.

Concept (C) – Oral health in school health curriculum.

Studies were included only if the health education was delivered in a curriculum format. It implies that the health education sessions are organized with proper time scheduling, lesson plans, and evaluation procedures.

Context (C) – School.

Only school-based studies were included in this scoping review.

Databases like PubMed, SCOPUS, ProQuest, CINAHL (Ovid), Dentistry & Oral Sciences Source (Ovid), Cochrane Library, Web of Science, Google Scholar, ERIC, and Epistemonikos were searched until 26th August 2023, using the PCC format to select published and unpublished literature. Government websites like the US Department of Health and Human Services [20] and websites of professional associations like American Dental Association [21] were also searched for school health curriculum documents (Supplementary Table 2. Websites searched for policy and guideline documents). Eligible studies were included irrespective of specific geographical or time limits or language barriers.

Search strategy for each database consisted of Medical Subject Headings (MeSH) terms like “Child” and free text words like “Oral health curriculum”. To check the appropriateness of keywords, a pilot search of PubMed database was carried out on 23–04–2023 with the search strategy of (((((("Oral health curriculum") OR ("oral health education")) OR ("dental health curriculum")) OR ("oral health subjects")) OR ("oral health module")) OR ("Oral health instructions")) AND ((("Schoolchildren") OR ("school students")) OR (("Child"[Mesh]) OR (Child*))) that yielded 768 results (Supplementary Table 3. Pilot PubMed search strategy and corresponding search results). Potentially eligible studies from the various databases were imported into Covidence software [22].

Stage 3 – Study selection

Specific inclusion and exclusion criteria were used for screening the documents. Only documents based on school setting were included. Grey literature like news bulletins and thesis were included to cover policy-level and implementation-oriented evidence that is not covered in peer-reviewed publications. Those documents that focused on children in other settings like hospitals and home were excluded. Documents that did not mention the ‘curriculum’ but followed a curricular format like pre-scheduled classes and fixed assessment methods were included. Documents about oral health education programs that did not follow the curricular format were excluded. There were no language or year restrictions.

The title and abstract screening were undertaken independently by two reviewers (PB and RV). Duplicates were removed by Covidence software. This was followed by an independent full-text screening by two reviewers (PB and RV). The full text of documents that aligned with the selection criteria of this scoping review were retrieved and reasons for the exclusion of documents at each stage were recorded and presented as a PRISMA flow diagram (Fig. 1. PRISMA 2020 flow diagram of study selection). Conflicts during these screening stages were resolved through discussion and consensus, and if required, third reviewer (VK) adjudicated. Though no formal quantitative agreement like kappa statistic was calculated, consistency was ensured through pilot calibration exercises of reviewers. Since this scoping review involved heterogeneous documents like curriculum and news bulletin, risk of bias assessment was not undertaken.

Fig. 1.

PRISMA 2020 flow diagram of study selection

Stage 4 – Charting the data

Data extraction was done using a tool developed by the authors (PB, RV, CJ, VK). Data recorded included general information like the author’s name (last name of the first author), year of publication, journal name or website, the country in which the curriculum was developed, type of curriculum, language in which the curriculum was published; details of the curriculum like developers of the curriculum, year from which it is implemented, alignment with government programs, topics included, curriculum instructor, stakeholders involved, type of school and grades focused, involvement of family, other skills developed through the curriculum and outcomes assessed.

Extraction process was undertaken by a reviewer (PB) and a second reviewer (RV) independently checked the extracted data. Any disagreement in the extracted data between the first and second reviewers was resolved by discussion with a third reviewer (CJ). A piloting of the data extraction step was carried out independently by the reviewers with five selected studies for calibration of the reviewers, standardization of the data extraction format, and to ensure the validity of this step.

Stage 5—Collating, summarizing, and reporting results

Data pooling and tabulation were undertaken based on pre-determined themes identified by authors like use of the term ‘curriculum’, curriculum type, aspects of oral health covered, contents of the oral health curriculum, schools and grades focused, involvement of family, mode of curriculum delivery, language used and instructor.

The extracted data was summarized using descriptive statistics (frequency or percentage) for categories like country, type of document, instructor, methods used, language, and type of curriculum. Since there was a wide range of oral health topics covered, these were further sub-categorized into headings like healthy mouth, harmful habits, dental problems, prevention, habits, nutrition, and tooth. Miscellaneous topics included in single document like association between oral health and school success, dentistry as a career, and oral fads were included as ‘Others’.The results are reported in narrative form along with graphical or tabular presentation.

Results

Of the 5035 documents imported into Covidence software, 2649 documents underwent title and abstract screening after duplicate removal. From this, 144 documents underwent full text screening. Due to deviation from the specified selection criteria, 102 documents were excluded. Final data extraction was done on 42 documents that included six documents, four news bulletins, nine websites, one dissertation, one conference proceeding, one online media, and twenty studies including six reviews. The heterogeneity of document types and reporting formats limited both comparison across studies and ability to synthesize standardized outcomes. These documents were from different countries with the US leading the list. Prevention of oral diseases was the focus of these included documents. This review shows that family was involved in the curricular dissemination and activities.

Characteristics of included studies

We categorized the review findings according to the four review questions as follows:

Primary review question—What are the different health curricula available for oral health for schoolchildren globally?

Our review shows that the earliest mention of school oral health curriculum was Natural Nashers in 1981 [23]. However, majority of literature (n = 29) discussing oral health component in school health curricula were published after the year 2000. Only five documents were published prior to the year 2000 and the remaining eight documents were primarily websites that did not specify years of curriculum publication. Based on the type of document, there were twenty articles, nine websites, six curricula, four news, one conference proceeding, one online media and one dissertation (Fig. 2a. Characteristics of included documents by type).

Fig. 2.

Characteristics of included by: a Type b Country c oral health topics in curricula d mode of curriculum delivery e curriculum instructor

Majority of documents were from the United States of America (n = 15) [21, 24–37], followed by seven [38–44] from India, and six [45–50] from the United Kingdom. Canada had three documents [51–53] and Philippines [54] and African country Rwanda [55] had one document each that was related to school oral health curriculum (Fig. 2b. Characteristics of included documents by country). The remaining nine documents were unspecified. Of the total four literature that were news, three belonged to the United Kingdom. Indian literature was mainly studies that described trials or observational studies related to oral health curriculum in schools. The only literature from the African region was a conference abstract of a study based in Rwanda [55].

Use of the term ‘curriculum’ is critical in this scoping review. It was found that thirty-three documents used the term 'curriculum’ to denote oral health education modules disseminated at fixed time periods based on a pre-planned schedule. Alternative terms used were oral health education program [29, 54], dental health education [52], oral health initiative [24, 46], oral/dental health education materials, [24] grade-appropriate lessons and activities, [24] oral health lesson plans, [25, 56] and oral health related content [38] (Fig. 3. Frequency-based representation of the term “curriculum” and its alternative).

Fig. 3.

Frequency-based representation of the term “curriculum” and its alternative

Curricula primarily addressed topics like benefits of good oral hygiene and healthy teeth, importance and steps of proper brushing technique, role of healthy diet, and regular dental check-ups. Others were functions of teeth, oral health care habits, primary teeth, flossing, plaque, dental caries, and harmful habits like tobacco, alcohol, and drugs. Five documents described the importance of fluorides [29, 31, 32, 39, 41] while two documents highlighted the association between oral health and general health [35, 36]. Some curricula also described careers in oral health [25, 36], association between oral health and school success [27], role of mass media and other sources of health and safety information in the community [37], and oral fads [36] (Fig. 2c. Characteristics of included documents by oral health topics in curricula).

Preventive aspects of oral health predominated the treatment counterpart in oral health school-based curricula. Thirty documents addressed preventive components like good oral health behaviors, use of fluorides and importance of periodic dental check-ups. Along with this, three curricula involved provision of treatments like pit and fissure sealants, scaling, and atraumatic restorative treatment [24, 33, 54].

Most documents did not specify the type of schools involved and the remaining documents presented diverse details of the curriculum implementing schools. Government-run schools were mentioned in six documents [38, 39, 41, 42].There were oral health curriculum developed for schools with specific students population like the ‘Brush’ oral health curriculum for schools in Indiana with children from low income families [27] and the “Bright Smiles, Shining Futures” curriculum implemented in US schools for immigrant children [35].

Our review shows that oral health curricula mainly target primary school children (n = 16 documents), followed by middle schools (n = 10 documents), high schools (n = 9 documents), and kindergartens(n = 7 documents).Two curricula were designed for children from kindergarten to high school [51, 57] while five curricula covered primary, middle and high schools. [38, 41, 45, 48, 49]Some curricula focused on two sets of grades like kindergarten with primary classes [24, 31, 32, 36, 36], and middle school with high school [37]. Some curricula catered to specific grades like the Head Start Dental Health curriculum designed exclusively for preschools in the US [29]. Similarly, four [34, 40, 50, 54], two [25, 30], and one [39] curricula focused solely on primary, middle, and high schoolchildren, respectively. The oral health curriculum developed by Alba et al. focused only on sixth grade students [30].

Besides the students and school managements, other stakeholders involved in oral health curriculum activities were teachers (n = 21 documents), early childhood educators (n = 4 documents),healthcare personnel like Women Infant Child staff, area dental officer, dentists, dental students, school nurse, dental health educator, dental hygienist, or dental therapist (n = 12 documents), family (n = 9 documents), professional associations like the American Dental Association (n = 1 document). Initiatives like Campaign for Tobacco Free Kids (n = 1 documents) were part of oral curriculum implementation at schools. Additionally, Municipality office [54], school health advisory board [37], Dental school [54], and Department of Health [37] were part of curriculum implementation (Table 1. Characteristics of included documents) Findings of included reviews are presented in Supplementary Table 4. Summary of findings of included reviews.

Sub question 1—What are the types of school health curriculum (integrated or stand-alone) that includes oral health?

Although most of documents did not specify the type of curriculum, one document mentioned a standalone curriculum [41] and eleven documents referred to integrated curricula [27, 32, 36–38, 42, 45, 47, 50, 53, 54] (Table 2. Types of school oral health curriculum).

Sub question 2—What educational methodologies were followed in these curricula?

This review shows that school oral health curriculum is primarily delivered by lectures (n = 12 documents) [29, 31, 32, 36–38, 41, 44, 49, 50, 52, 55], followed by demonstrations using models, roleplays, stories, videos, or PowerPoint presentations (n = 7 documents) [30–32, 44, 50, 52, 54], and activities using charts, posters, or worksheets (n = 6 documents) [29, 31, 32, 44, 50, 52] (Fig. 2d. Characteristics of included documents by mode of curriculum delivery).

Based on the pooled literature, the school oral health curriculum was delivered mostly in English(n = 28 documents). An important finding was the limited use of native language which is an important determinant of educational effectiveness among children. Three curricula were delivered in English and Spanish. [26, 27, 30]An Indian school oral health curriculum used both English and the local language Marathi. [38]A school oral health curriculum in the US used native language equivalents and help from language translators along with English curriculum [35].There was also a curriculum delivered in the local language of Philippines [54] (Table 3. Details of the educational methods followed in included documents).

Thirteen documents included the student’s parents/family as stakeholders in the oral health curriculum. Their roles involved being the resource person, partners in curriculum-based activities, supervision of home-based oral health behaviors as well as providing feedback. The remaining documents (n = 29) did not mention family involvement (Table 3. Details of the educational methods followed in included documents).

While the school teacher was the instructor in most of the curricula (n = 23 documents), dental health professionals like dentists [39, 41], dental students [50], interns [54], dental hygienists [32, 46], and dental hygienist-therapists [46] also participated in oral health curriculum coaching. Additionally, early childhood educators and parents were instructors of a curriculum [26] (Fig. 2e. Characteristics of included documents by curriculum instructor).

Sub question 3—What is the existing evidence regarding school oral health curriculum assessments?

Eleven documents mentioned assessments of the school oral health curriculum. PowerSchool learning software system was used for pre and post modular assessment in a curriculum for sixth grade students in San Diego county. [30]Other assessment methods include Question& Answer sessions [32, 54], multiple choice questions [34, 54], recording dental indices [23, 32, 39, 41, 54], dental health knowledge questionnaires, [23, 39, 41, 50, 53]student determined basic psychological need satisfaction scale [53], activities to assess knowledge and skills [37], and pre- and post-module tests [36, 37] (Supplementary Table 5. Outcome assessment methods reported in the included documents).

Improvement in oral health knowledge was the main outcome assessed. This was achieved using questionnaires. [23, 39–41, 50]Changes in attitude towards oral health were also assessed using questionnaires. [23, 36, 37, 39, 41] Dental caries experiences like changes in number of decayed, missing or filled teeth was scored using DMFT or def indices [23, 39, 41]. This index also provides insights on the dental care services availability and utilization. The oral hygiene status was scored by indices like Patient Hygiene Performance Index [32], OHI-s, and Plaque Index [23, 40]. Severity and location of gingivitis was recorded by Gingival index [23] (Supplementary Table 6. Outcome assessment methods used in school oral health curricula).

Discussion

This scoping review was designed to identify oral health components in global school health curricula. Key areas of focus were the type of curriculum, mode of delivery, topics, instructor, and family involvement. The review findings were organized around the primary review question and three sub questions.

The review identified 42 documents from diverse sources like websites, news bulletins, articles, and projects. Websites of associations like American Dental Association [57], regional health and education departments like that of York [51], and websites that focus on oral health of children like Brush dental and Cavity free kids provided valuable resources. Additionally, news sections in various journals highlighted the reinstatement of previous oral health curriculum [46] or introduction of a new curriculum [45, 47].

Most documents were published post- 2000, indicating a growing emphasis in this often-neglected domain. The USA was the leading contributor, with curriculum documents [21, 26, 57], government websites [51], and projects [30]. This shows a robust and multi-faceted commitment to provide oral health promotion in the US schools. Despite being the second major contributor to this review, India had small-scale primary studies and protocols except for a training manual for schoolteachers. This disparity between countries demonstrates the sustained and action-oriented approach in the developed countries, while the latter being limited to research. High-income countries like the United States and United Kingdom features structured curricula that are integration into formal education systems, whereas evidence from low- and middle-income countries is largely limited to pilot studies or short-term interventions. Integrated curricula appear more feasible in resource-constrained settings of low-income countries due to reduced demand for dedicated teaching time and personnel. Moreover, limited documents from other countries reflect broader global disparities and a call for action in this regard.

A novel finding of this review was the distinction between the term ‘curriculum’ and its related terms like dental health education and oral health education program. These nuanced differences highlighted the variation in their scope, focus, conceptualization, and implementation of these initiatives. A school oral health curriculum is a systematic approach to teach students about oral health through lectures and activities coupled often with timely assessment to monitor the result. It ensures that classes take place in a structured manner on a regular basis. This systematic and comprehensive approach is not represented by the alternatively used terms. Though the majority of the synonymously used terms adhered to the context of curriculum used in this review, it can be anticipated that sustainability and proper implementation of the initiative will be better assured if the term ‘curriculum’ is used.

Most curricula covered important topics like benefits of good oral hygiene, toothbrushing technique, diet, and the need for regular dental check-ups. A few also included lessons on tobacco, interdental aids, role of plaque and dental caries. These topics nurtures proper dental health knowledge to prioritize prevention over treatment. Prevention of dental diseases was the foci of majority of included documents. This aligns with the policies of World Health Organization and FDI World Dental Federation policy of focusing on prevention of oral diseases [58, 59].

The types of schools targeted were another review finding, although this information was missing in most documents. Notably, there were curriculum for schools with immigrants students and those from low-income families [27, 35]. Primary school grades were given more thrust than other grades, likely to foster desirable habits from a young age. Early nurturing of healthy practices and awareness ensures its sustainability. It also ensures appropriate care for the often-neglected primary teeth and aids in developing a positive attitude towards oral health and dental treatments [60]. These efforts also pave way for a ripple effect as oral health curriculum activities in primary schools may influence the child’s family members. Consequently, the review identified a wide range of stakeholders like family, dental healthcare professionals, student dentists, government agencies, and professional associations.

Integrated curricula outnumbered its standalone counterpart. Integrated curriculum dates back to 1835 when John Frederick Herbart argued that “subjects should not be taught as individual subjects independent of others” [61]. Limited attention to health in school curriculum coupled with the scarcity of specialist teachers, teaching aids, and separate budget allocation had led to the development of Action-oriented integrated school curriculum by the WHO Regional Office for the Eastern Mediterranean (WHO-EMRO) and the United Nations Children's Fund (UNICEF) in 1985 [62]. This approach incorporates health lessons with other school subjects and activities like mathematics, science and arts. The oral health curriculum by Chapman et al. incorporated oral health lessons with science and literacy class [50]. Dagar et al. integrated oral health contents in science textbooks [38].

Limitation of radical reformation that is often involved in integrated curriculum had resulted in stand-alone curriculum in which oral health lessons are taught as separate subject as seen in the curriculum by Karuveettil et al. [41] Nevertheless, experts are yet to elucidate which type of curriculum yields better student outcomes [61].

Lecture were found to be the primary method of curriculum delivery. This was also supplemented by discussion and activities in some curricula. English was the commonly used language except for a curriculum in the local language of Philippines [54]. A few curricula used both local language and English versions. This reflects a critical gap in the curriculum implementation. Local language delivery of curriculum is a critical determinant of its effectiveness as it will enhance its comprehension, adaptation, and retention by the students.

Parents and occasionally, other family members played active roles in curriculum implementation while schoolteachers were the primary curriculum facilitators. Involvement of parents and teachers have been found to enhance the learning experience of students [63] with successful outcomes established by curriculum enrichment model [64] and partnership model [65] of stakeholder involvement in school curriculum.

Although assessment is a critical component of curricula, it was only sparsely mentioned in the form of softwares, scales, and questionnaires. This limited presence prevented assessment being considered as an inclusion criterion in this review. Improvement in oral health knowledge was the primary outcome assessed. Others were positive attitude towards oral health, improved oral hygiene practices, and decrease in caries experience.

Strengths and limitations

Besides focusing on the term ‘curriculum’, this review included alternatively used terminologies thereby ensuring a comprehensive coverage of documents. Additionally, an extended search across ten databases, along with reference searching and exploring diverse websites strengthened our search to yielded diverse findings covering the entire spectrum of this topic of interest. These strengths provide concrete framework for future oral health initiatives curriculum and policy development.

However, several limitations must be acknowledged. The absence of standardized terminology across studies limited comparability and introduced challenges in synthesizing findings. The inclusion of heterogeneous sources, while necessary for comprehensiveness, resulted in variability in methodological rigor and reporting quality. Furthermore, the lack of uniform outcome measures across studies restricted the ability to assess the effectiveness of curricula in a consistent manner. Finally, the uneven geographical distribution of evidence, with underrepresentation from several regions, limits the generalizability of the findings to a global context.

Conclusion

This scoping review identified 42 documents on oral health within school curricula, revealing limited and heterogeneous evidence despite the substantial global burden of childhood oral diseases. Key gaps include insufficient coverage of the oral–systemic health link and limited attention to diverse influences on oral health behaviors. These findings highlight the need for more comprehensive research and standardized frameworks to guide curriculum development and evaluation.

Strengthening the integration of oral health into school health programs has the potential to promote lifelong healthy behaviors and improve child oral health outcomes.

Authors’ contributions

**PB:** Data Curation; Formal analysis; Writing—original draft (Lead); Writing – review and editing (Lead), Software, Methodology. **CJ:** Conceptualization (Lead), Methodology (Lead); Writing – review and editing; Supervision. **RV:** Writing – Original draft (Supporting); Writing – review and editing; Software (Lead), Methodology. **VK:** Methodology; Writing – review and editing. All authors approved the final version of the manuscript.

Funding

Open access funding provided by Amrita Vishwa Vidyapeetham. None to declare.

Data availability

The datasets generated and/or analyzed during the current study are not publicly available due to copyright and database licensing restrictions but are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.