Factors related to oral health behavior among primary schoolchildren in rural Armenia

BACKGROUND: Oral health (OH) of children is very important for their physical and mental health and wellbeing. OH is known to be tightly linked to OH behavior. There is lack of studies on children's OH behavior in rural Armenia. This study aimed to measure OH behavior among primary schoolchildren in two villages of Armenia and identify factors associated with their desired OH behavior. METHODS: A cross-sectional study among schoolchildren and their primary caregivers (parents) was carried out in 2022 in Sardarapat and Mrgashat communities of Armavir province, Armenia. Overall, OH status of 400 schoolchildren was assessed by a dentist, and their parents participated in a telephone interview. The survey questionnaire included items on parent's OH knowledge, child's OH behavior and nutrition practices, and family's socio-demographic characteristics. Multiple linear regression model was fitted to identify factors associated with child's OH behavior score. RESULTS: The mean age of children was 8.3 years, and the mean age of their caregivers was 33.6 years. Children's mean OH behavior score was 1.8 of the maximum of 5 (i.e. 36% score); nutrition practice score was 6.0 of 14, and parental OH knowledge score was 6.9 of 9. Factors positively associated with child's OH behavior in the adjusted analysis included child's nutrition practice score (B = 0.07; p = 0.026), parent's OH knowledge score (B = 0.12; p = 0.002), higher than secondary education of parent (B = 0.22; p = 0.042), and family's higher than average living standards (B = 0.48; p = 0.051). CONCLUSIONS: The study identified that OH behavior of primary schoolchildren in rural Armenia was poor. It could be improved through increasing the knowledge of parents on child's desired OH behavior and nutrition practices. An unexpected finding was the lack of association between children's OH behavior and objective measures of their OH - plaque index and DMFT (number of decayed, missing due to caries and filled permanent and primary teeth). KEY MESSAGES: • Rural children’s OH behavior in Armenia was mainly poor. To address this issue, parents should be educated on correct child care practices including child’s oral health and nutrition behavior. • Further research is needed to explain the reason of the lack of association between objective measures of child’s oral health (plaque index and DMFT) and child’s OH behavior score.