Impact of the COVID-19 Pandemic on Oral Health Behaviors Among Children in Iran

Objectives: Parents are responsible for their children's oral health. This study evaluated parents' knowledge, attitudes, and performance on their children's oral health before and after an educational intervention and the impact of COVID-19 on these variables. Material and Methods: This quasi-experimental study included 227 children aged 6-8 years who were referred to 11 Shiraz medical centers from July to December 2021. Data were collected from questionnaires and interviews. After completing the questionnaire, oral health education was provided immediately and then monthly thereafter using dental models and pamphlets. After 3 months, a questionnaire assessed the education's effectiveness. Data were analyzed using independent t-tests, one-way analysis of variance (ANOVA), paired t-tests, and Pearson's correlation. Results: A total of 163 participants (71.80%) completed all phases, including the second questionnaire. Participants showed moderate knowledge (77.30%), attitude (89.00%), and performance (80.40%). Neither knowledge nor attitude before the intervention had a significant association with demographic characteristics. Parents' education, number of children, and maternal employment were significantly associated with performance (p = 0.002, p = 0.040, p < 0.001, respectively). The intervention significantly enhanced these variables (p < 0.001). In terms of COVID-19, 72.40% of participants expressed good knowledge about transmission, 52.80% showed moderate concern, and 54% had poor performance. Parental knowledge, attitude, and performance changed significantly following the intervention (p = 0.030, p < 0.001, p < 0.001, respectively). Conclusions: Educational intervention significantly improved parents' knowledge, attitudes, and performance toward children's oral health. Because of the poor performance of parents during the COVID-19 pandemic, we recommend the implementation of continuing education and preventive oral health programs.