Limitations
This study had some limitations. In the process of data collection, some parents did not return the signed consent form and did not complete the questionnaire. However, reminders were sent to increase the response rate of the parents. Moreover, the process of collecting the completed questionnaires from parents was time-consuming. Besides, there was limited control over parents’ supervision of children’s brushing behavior at home. In order to overcome this limitation, a weekly plan (diary) was given to parents in order to facilitate supervision over their children. Furthermore, some parents were not interested in participation in the educational session. Since the CAST index is more complex compared to the DMFT/dmft index, the calibration and examination process required more time. However, in order to reduce the risk of misdiagnosis in the examination process, a visual aid containing the CAST index classification details was used during examination and calibration.