The goal of this intervention study was to evaluate the effectiveness of a two-month interactive school-based oral health education program in reducing periodontal disease and improving oral health behaviors among 15-year-old schoolchildren in Nablus, Palestine.

The study was guided by the following hypotheses:

• The interactive education program would lead to a significant reduction in Community Periodontal Index for Treatment Needs (CPITN) and Simplified Oral Hygiene Index (S-OHI) scores.
• The program would result in significant improvements in oral hygiene practices, dietary habits, and smoking behaviors compared to standard oral health education.

Researchers compared students who received six interactive oral health sessions over two months to those who received a single standard oral health lecture, to determine whether the intervention group experienced greater improvements in periodontal status and self-reported health behaviors.

Participants:

• Completed self-administered questionnaire assessing oral hygiene practices, dietary habits, and smoking behaviors
• Underwent clinical periodontal examinations using CPITN and S-OHI indices
• Participated in oral health education sessions (intervention group only)

This completed clinical trial evaluated the effectiveness of an interactive, school-based oral health education program in improving periodontal health and associated behaviors among 9th-grade students in Nablus City, Palestine. The study employed a double-blind, pre-test/post-test experimental design involving 946 students (536 intervention, 410 control) from 15 schools selected through stratified random sampling.

Baseline data collection occurred in March 2024 and included clinical assessments using the Community Periodontal Index for Treatment Needs (CPITN) and Simplified Oral Hygiene Index (S-OHI), along with a validated 47-item questionnaire measuring oral hygiene practices, dietary habits, and smoking behaviors. Following randomization by school, the intervention group received six interactive oral health education sessions, while the control group attended one standard lecture. Follow-up assessments took place two months later.

Two levels of blinding were implemented: participants were unaware of group assignment, and outcome assessors were blinded during clinical evaluations. The educational program combined audiovisual materials, live demonstrations, group discussions, and hands-on practice focused on oral anatomy, prevention and treatment of periodontal disease, smoking harms, and nutrition.

Primary outcomes included changes in CPITN and S-OHI scores. Secondary outcomes addressed self-reported improvements in oral hygiene, dietary behaviors, and smoking habits. Data analysis was performed using SPSS version 25.0, with paired and independent t-tests applied to evaluate within- and between-group differences.

The findings indicated significant improvements in the intervention group across all primary and secondary outcomes. These results support the program's effectiveness in enhancing periodontal health and related behaviors among adolescents through interactive, school-based education.

Inclusion Criteria:

• Adolescents enrolled in 9th grade at one of the selected governmental or private schools in Nablus City during the 2023-2024 academic year
• Age approximately 15 years (index age for adolescence as defined by the World Health Organization)
• Willingness to participate and availability for both baseline and two-month follow-up assessments
• Provision of written informed consent by a parent or legal guardian, and written assent by the student
• Ability to complete the study questionnaire and undergo clinical periodontal and oral hygiene examinations

Exclusion Criteria:

• Students who were absent from school for medical or other reasons at the time of baseline screening
• Inability or unwillingness to comply with study procedures (e.g., not completing the questionnaire, refusing periodontal examination)
• Refusal to provide either parental/guardian consent or student assent

The de-identified individual participant data (IPD) that underlie the results reported in this interventional study (including demographic variables, clinical measurements, and outcome assessments) will be made available beginning one year after publication for researchers who provide a methodologically sound proposal. Data will be shared via a public repository (e.g., Dryad) with a digital object identifier (DOI) to ensure persistent access. Interested investigators should contact the corresponding author (sura.kazlak@yahoo.com) to request data and submit a brief research proposal. Data will be provided under a data-use agreement prohibiting participants' re-identification and further sharing without permission.

IPD will be released 12 months after publication of results and remain available for 5 years thereafter.

Blinding was applied at the participant and outcome assessor levels. Participants were not informed of their group allocation, and assessors conducting data collection were blinded to reduce assessment bias. The educator administering the intervention was not blinded, as this was not operationally feasible.