Discussion
’s behaviors, ’s behavior, caries
CARIES
The present study evaluated the one-year impact of an oral health promotion program including parents’ education and supervised toothbrushing on oral health status of schoolchildren aged 6–7 years old. One year after implementing the program, the changes in the parents’ attitude and children’s behavior were marginally significant in the intervention group. According to the CAST index, there was less caries in deciduous molar teeth in the intervention group compared to the controls. In addition, a significant improvement observed in the oral hygiene status of children according to the OHI-S index in the intervention group compared to the control group. An improvement observed in the level of oral health related knowledge and self-reported behavior of parents that received the intervention package compared to the controls although the difference was not significant.In the present study, evaluation of the caries status based on the CAST index showed that the percentage of caries in primary molars (CAST score ≥ 3) was significantly lower in the intervention group compared to the control group one year after the initial examination and receiving the educational interventions. Our findings are consistent with the results of longitudinal studies by Peterson et al., [After one year, the children’s oral health status was compared between the control and intervention groups using the OHI-S index. In this regard, the findings of the present study showed a significant improvement in the oral health status of children in the intervention group in the one-year follow-up according to the OHI-S index. This finding was consistent with the results of a systematic review by Stein et al. in 2017 [A recent review of Gargano et al., in 2019 advocated the involvement of parents in oral health programs in addition to stakeholders from different levels [In the present study, a comprehensive package including education workshop and supervised toothbrushing delivered. Our intervention package was prepared according to the recommendations of the World Health Organization (WHO) [In the present study, both children and their parents were targeted for the oral health promotion program. According to the literature, the programs targeting children, parents, and teachers at the same time are more promising. This finding is consistent with a review study by Cooper et al. in 2013 that found that these interventions had a positive effect on maintaining oral health in children aged 4 to 12 years [After one year, the mean score of the parents’ oral health related knowledge, attitude and self-reported behavior was assessed in both groups. Although the parents’ attitude and the children’s behavior change were marginally significant in the intervention group, the difference was not significant. In this regard, the GEE analysis showed that the improvement of the parent’s attitude and children’s behaviors was marginally significant in the intervention group. In the present study, similar to a study by Gholami et al. [