Al‐Jundi 2006

Methods	Study design: randomised controlled trial Conducted in: Jordan Unit of randomisation: schools Unit of analysis: individual Setting: 4 schools, Irbid City, Jordan Funded by: "Higher Council for Science and Technology sponsored the program" Duration of the study: 4 years
Participants	Inclusion criteria: all children in selected schools Exclusion criteria: children with fixed orthodontic appliances, those with advanced systemic or periodontal disease Age at baseline: 6 to 12‐year‐olds (age group 1 = 6.3 years; age group 2 = 11.7 years) N (controls baseline): 436 N (controls follow‐up): 397 N (interventions baseline): 420 N (interventions follow‐up): 411 Recruitment: from schools Gender: at baseline, male = 412, female = 444
Interventions	Intervention: All children were examined annually in September over 4 years. The intervention group received 30‐minute oral hygiene instruction sessions on 5 consecutive school days. These included 10‐minute lecture given by the main author on the importance and methods of oral hygiene using a colour poster, 10 minutes on the method of toothbrushing using a large model and 10 minutes of practiced toothbrushing using the horizontal scrub method under supervision. The other component was daily supervised brushing with fluoridated toothpaste Control: Children in the control group received the same oral hygiene instruction sessions, but without practical demonstration and application of toothbrushing technique Duration of intervention: 30‐minute oral hygiene sessions
Outcomes	DMFT1/deft2, percentage caries free
Implementation related factors	Theoretical basis: not reported Resources for implementation: clinical examination tools, toothpaste, toothbrush, training, research assistant and dental hygienist Who delivered the intervention: main author, dental hygienist and research assistants PROGRESS categories assessed at baseline: gender PROGRESS categories analysed at outcome: gender Outcomes related to harms/unintended effects: not reported Intervention included strategies to address diversity or disadvantage: not reported Economic evaluation: The programme was deemed expensive because of the cost of providing supplies and disposable materials such as cups, napkins, etc., as well as paying the supervising person
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Only limited information was provided: method of sequence generation not described ‐ study states only "a random sample of male and female children in the first and sixth grades was drawn from lists provided by four schools"
Allocation concealment (selection bias)	Unclear risk	Unclear
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Unclear
Selective reporting (reporting bias)	Unclear risk	Unclear
Other bias	Unclear risk	Unclear
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Unclear
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Unclear