Effect of a Multimedia-Assisted Microteaching Program on Oral Health Knowledge, Behavior, and Oral Hygiene Status Among Indonesian Elementary School Children: A Mixed-Methods Study

<b>Background</b>: Dental caries and poor oral hygiene remain major public health problems among school-aged children, particularly in low- and middle-income countries. Teachers play a strategic role in delivering sustainable school-based oral health education; however, their effectiveness depends on appropriate pedagogical training. <b>Objective</b>: This study aimed to evaluate the effectiveness of a multimedia-assisted microteaching intervention for elementary school teachers in improving students' oral health knowledge, attitudes, practices, and oral hygiene status. <b>Methods</b>: A mixed-methods sequential explanatory design was employed. Quantitative data were collected from 582 students and their teachers across three groups: multimedia-enhanced microteaching, multimedia-only training, and a control group. Outcomes were assessed using Knowledge-Attitude-Practice (KAP) questionnaires, the Oral Hygiene Index-Simplified (OHI-S), and the Decayed, Missing, and Filled Teeth (DMFT) index before and after a two-month implementation period. Non-parametric statistical tests were applied. Qualitative data were obtained through focus group discussions with teachers and were analyzed thematically. <b>Results</b>: Students in the multimedia-enhanced microteaching group demonstrated greater improvements in KAP scores and OHI-S values compared with the multimedia-only and control groups (<i>p</i> < 0.05). Qualitative findings indicated increased teacher confidence, improved classroom engagement, and better integration of oral health education into daily lessons. Changes in DMFT values were interpreted descriptively due to the short follow-up period. <b>Conclusions</b>: Multimedia-assisted microteaching appears to be a promising approach for strengthening teacher-led oral health education and improving short-term behavioral and hygiene outcomes among elementary school children. Further longitudinal studies are needed to assess long-term clinical effects.