The
objective was to find out 1) if the national recommendation has had any effect on
schools’ oral health-promoting actions, 2a) whether the school-level intermediary
determinants were associated with the school-level socioeconomic position (SEP)
and 2b) whether the effects of the national recommendation on schools’
intermediary determinants differed according to the school-level SEP.

The
study is based on two datasets independently collected from Finnish upperlevel comprehensive
schools (N=970): the oral health-promoting actions (OHPA) data were collected
through an online survey arranged in 2007 (n=480), 2008 (n=508), 2009 (n=593)
and 2010 (n=478) and the oral health behaviour data via the national School
Health Promotion Study. The combined, longitudinal dataset (n=360) used in this
study was formed based on these two datasets. Aim 1 was investigated based on
the schools that responded to the OHPA survey in 2007- 2009 (n=258) and both in
2007 and in 2010 (n=237). The baseline and longitudinal combined data were used
to examine aims 2a and 2b, respectively.

The
national recommendation has influenced schools’ oral health-promoting actions:
schools have decreased their sweet snack and soft drink selling to pupils. In
addition, there seem to be associations between school-level intermediary determinants
and the school-level SEP. The impact of the national recommendation on the sale
of sweet products in schools was similar across all school-level SEP groups.

Overall,
the national recommendation was an effective tool to decrease sweet selling in
Finnish schools without increasing inequalities in sweet selling. To eradicate
the sale of sweet products altogether from Finnish schools, stricter actions
such as legislation prohibiting the sale of unhealthy products in schools may
be needed.