Integrating Oral Health Curriculum into Indian Schools: Evidence-Based Perspectives and Policy Recommendations for National Implementation from a trial in Kerala, India

Oral diseases, particularly dental caries, remain a pressing public health challenge in India, affecting a significant proportion of children and contributing to long-term health, social, and economic consequences. Despite numerous health initiatives, structured, evidence-based oral health education is still insufficiently integrated into school curricula, limiting opportunities for early prevention and the development of lifelong healthy behaviors. Drawing on a cluster-randomized trial conducted in Ernakulam district, Kerala and an umbrella review of 27 systematic reviews and, this perspective highlights the effectiveness of a structured oral health curriculum, “Everlasting Smiles.” Delivered over 24 months by both dental professionals and trained schoolteachers, the program significantly improved children’s oral hygiene practices, knowledge, attitudes, and behaviors, while also reducing dental caries increment and plaque and gingival indices, with dentist-led interventions achieving superior outcomes. These findings highlight that school-based oral health education, when delivered consistently and supported by appropriate training, preventive services, and community engagement, can play a transformative role in reducing disease burden and fostering preventive health culture from an early age. Integrating standardized oral health modules into the national curriculum, accompanied by policy support, dedicated funding, and multi-sector collaboration, offers a scalable strategy to equip children with lifelong oral hygiene skills, reduce oral disease prevalence, and contribute to healthier, more informed generations across India.