Oral health seeking behaviours and attitudes: Perspectives and practices of parents and teachers in Islamic boarding schools in Pakistan

Religion and culture strongly influence daily life in many populations. Children rely on the beliefs and habits of parents, caregivers, and teachers to manage their oral health. This study explored the oral health knowledge, perceptions, hygiene habits and care-seeking behaviours of parents and teachers of children attending Islamic boarding schools in Pakistan. A qualitative study was conducted in Lahore, Pakistan, during May-June 2024, including Focus Groups (FGs) with teachers (N = 3) and semi-structured interviews with parents (N = 17). Purposive sampling was used to recruit participants. Interview guide was based on research questions and previous literature. Interviews were audio-recorded, translated, and transcribed in English for thematic analysis. From the thematic analysis, two overarching themes emerged: (A) religion, culture, and oral health, and (B) attitudes, behaviours, and oral health. These themes were further divided into two and three major subthemes, encompassing six and eight minor subthemes, respectively. The major subthemes from theme (A) were: 1) oral health as part of Islamic religious teachings, and 2) the use of alternatives to toothbrushes. For theme (B), the major subthemes included: 1) brushing habits and dental problems among parents and children, 2) oral health-seeking behaviour and its barriers, and 3) the positive role of schools. This qualitative study offered deeper insights from teachers and parents for improving children's oral health. To effectively educate children, culturally and religiously sensitive health campaigns involving parents and religious teachers at schools are essential, as these adults serve as role models for establishing lifelong habits, including good oral hygiene practices. • Religio-cultural influences and personal rationale impact oral health. • Parents and teachers believed that home remedies are better in tackling dental problems than going to a dentist. • Key barriers to seeking dental treatment included high cost, fear of pain and lack of trust in dentists. • Schools should encourage regular brushing, organize dental camps, lectures and provide dental products to children.