Parental oral health knowledge and plaque index of their children in rural communities of Armenia

BACKGROUND: While the prevalence of oral diseases in high-income countries is decreasing, the opposite is true in low and middle-income countries. Parental awareness about oral health has been shown to be an important contributor to children's oral health. This study evaluated the association between parental oral health knowledge and the oral health status of their children aged 6-10 years in two rural communities of Armenia. METHODS: This cross-sectional study included two main components: telephone survey among parents measuring sociodemographic, oral health knowledge, and behavioral variables, and clinical examination of children's oral health. Multivariable linear regression was used to identify the adjusted association between parental oral health knowledge score and children's oral health measured by plaque index. RESULTS: A total of 400 pairs of parents and children participated in the study. The mean plaque index among children was 3.1 (out of the maximum 5.0), demonstrating abundant coverage of teeth with plaque. The mean parental knowledge score was 6.9 (out of the maximum 9.0), indicating above-average oral health awareness. The items with the lowest proportion of correct responses were the belief that caries is preventable, the importance of daily flossing, and using fluoride-added toothpaste/water for preventing caries, with 75.1%, 60.4%, and 59.9% of correct answers respectively. The multivariable analysis found negative association between parental oral health knowledge score and children's plaque index (B= -0.24, p = 0.039), when controlling for other significant variables. CONCLUSIONS: The study confirmed the importance of parental oral health knowledge for the oral health of their children and highlighted the knowledge gaps that should be addressed. The high prevalence of dental plaque among the children emphasized the need for complex interventions, including educational activities, preventive clinical procedures, and improved access to dental care. KEY MESSAGES: • In two rural communities of Armenia, there was a clear link between parental oral health knowledge and oral health status of their primary schoolchildren measured by plaque index. • Well-focused educational interventions targeting parents of primary schoolchildren combined with children’s better access to dental care are recommended for improving their oral health.