Association between parents’ oral health literacy and oral health status of 6–12-year-old children in Kashan, Iran

Parental oral health literacy (OHL) is increasingly recognized as a key determinant of children’s oral health. This study aimed to investigate the association between parental OHL levels and the extent and severity of dental plaque in children aged 6–12 years, as well as to examine relationships with caries experience and identify factors associated with parental OHL. This cross-sectional study was conducted in 2025 in Kashan, Iran, involving 203 parent–child dyads recruited from pediatric dental clinics using stratified random sampling. Parental OHL was assessed using the validated Oral Health Literacy Questionnaire for Adults (OHL-AQ), which evaluates reading comprehension, numeracy, listening skills, and decision-making. Children underwent intraoral examinations to assess dental plaque using the Silness & Löe (1964) index and caries experience using dmft/DMFT indices according to WHO criteria. The mean parental OHL score was 60.97 ± 22.78 out of 100. Mothers demonstrated higher literacy than fathers, and OHL increased with parental education ( p < 0.001). Behavioral factors such as frequent dental visits, flossing, and non-smoking status were positively associated with higher OHL ( p < 0.05). Children's mean plaque score was 1.32 ± 0.39, with 80.8% exhibiting moderate plaque severity. Higher parental OHL correlated with increased plaque severity ( p = 0.006), fewer decayed primary teeth ( p = 0.009), and more filled primary teeth ( p < 0.001). No significant associations were observed with permanent teeth DMFT indices. These findings suggest that parental OHL may be an important factor associated with children's oral health. However, the unexpected positive association between higher parental OHL and greater plaque severity suggests that the relationship between parental literacy and children's plaque control is complex and may be influenced by factors not captured in this study. Enhancing parental OHL through targeted education may improve children's oral hygiene, reduce untreated caries, and promote the use of preventive dental care. These findings highlight the importance of family-centered oral health interventions in pediatric populations.