The Impact of Oral Health Education via Telegram and Traditional Methods on Parental Knowledge, Attitudes, and Practices, and the Oral Health Status of 6-12-year-olds in Tehran, Iran: A Three-Month Follow-Up Trial in 2023

Document Type : Original Article

Authors

1 School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

2 Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran and Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran

3 32bit Mobile Medizine GmbH, Berlin, Germany; SRH University of Applied Sciences, Berlin, Germany

Abstract

Background: Virtual interventions have demonstrated positive outcomes by promoting equitable access to care. We compared the impact of oral health education through Telegram social media versus traditional methods on parents’ knowledge, attitudes, and practices, as well as the oral health status of children.
Methods: This randomized controlled trial involved parents and their 6- to 12-year-old children referring to the School of Dentistry from January to March 2023. Participants were randomly assigned to social media education or received a printed booklet (traditional education). Parents completed a questionnaire, and children underwent clinical examinations before and after the three-month follow-up. Statistical analysis was performed using independent samples t-test and repeated measures ANOVA.
Results: Among 51 participants, 28 (54.90%) were males. In both groups, Plaque Index (before 1.466 ± 0.632, after 0.538 ± 0.514, P < 0.001 in the virtual education group and before 1.056 ± 0.575, after 0.663 ± 0.470, P < 0.001 in the traditional education group) and the Gingival Index (before 0.486 ± 0.513, after 0.146 ± 0.414, P < 0.001 in the virtual education group and before 0.244 ± 0.324, after 0.139 ± 0.256, P = 0.004 in the traditional education group) decreased significantly following the intervention.
A comparison of knowledge scores (before 7.769 ± 2.672, after 9.423 ± 3.689, P = 0.012 in the virtual education group, and before 8.640 ± 2.498, after 11.400 ± 3.027, P = 0.024 in the traditional education group) revealed significant improvements. Attitude scores (before 21.230 ± 4.563, after 22.500 ± 5.232, P = 0.027 in the virtual education group and before 20.240 ± 4.892, after 22.920 ± 3.904, P = 0.009 in the traditional education group) revealed significant improvements. Changes in the outcomes were not associated with the children’s age or gender.
Conclusion: Compared to the virtual education method, knowledge scores were higher in the traditional education group after the intervention. Given that both interventions improved children’s oral health status and enhanced parents’ perspectives about pediatric oral health, both methods are recommended to be used based on the context and available resources.

Keywords

Main Subjects

References

1. World Health Organization (WHO). Oral Health. WHO; 2024.
Available from: https://www.who.int/news-room/questions-andanswers/
item/oral-health. Accessed February 11, 2026.
2. Glick M, Williams DM, Kleinman DV, Vujicic M, Watt RG,
Weyant RJ. A new definition for oral health developed by the
FDI World Dental Federation opens the door to a universal
definition of oral health. Am J Orthod Dentofacial Orthop
2017;151(2):229-31. doi:10.1016/j.ajodo.2016.11.010
3. Mafi S, Salari N, Nazari Z, Alaee A. Assessment of the
relationship between xerostomia and oral health related quality
of life in cardiovascular patients. J Oral Health Oral Epidemiol
2025;14(1):1-7. doi:10.34172/johoe.2407.1676
4. Baiju RM, Peter E, Varghese NO, Sivaram R. Oral health and
quality of life: current concepts. J Clin Diagn Res 2017;11(6):
ZE21-6. doi:10.7860/jcdr/2017/25866.10110
5. Le Bars P, Matamoros S, Montassier E, Le Vacon F, Potel G,
Soueidan A, et al. The oral cavity microbiota: between health,
oral disease, and cancers of the aerodigestive tract. Can J
Microbiol 2017;63(6):475-92. doi:10.1139/cjm-2016-0603
6. Jalili Sadrabad M, Rohani H, Yahyaei F, Ghorbani R, Sohanian
S. Association between vitamin D deficiency and oral lichen
planus as a precancerous lesion. J Oral Health Oral Epidemiol
2024;13(4):170-4. doi:10.34172/johoe.2311.1603
7. McGrath C, Sham AS, Ho DK, Wong JH. The impact of dental
neglect on oral health: a population-based study in Hong Kong.
Int Dent J 2007;57(1):3-8. doi:10.1111/j.1875-595x.2007.
tb00111.x
8. Bradbury-Jones C, Innes N, Evans D, Ballantyne F, Taylor J.
Dental neglect as a marker of broader neglect: a qualitative
investigation of public health nurses’ assessments of oral
health in preschool children. BMC Public Health 2013;13:370.
doi:10.1186/1471-2458-13-370
9. Luxton DD, McCann RA, Bush NE, Mishkind MC, Reger GM.
mHealth for mental health: integrating smartphone technology
in behavioral healthcare. Prof Psychol Res Pr 2011;42(6):505-
12. doi:10.1037/a0024485
10. Anderson-Lewis C, Darville G, Mercado RE, Howell S, Di
Maggio S. mHealth technology use and implications in
historically underserved and minority populations in the United
States: systematic literature review. JMIR Mhealth Uhealth
2018;6(6): e128. doi:10.2196/mhealth.8383
11. Chau RC, Thu KM, Chaurasia A, Hsung RT, Lam WY. A
systematic review of the use of mHealth in oral health
education among older adults. Dent J (Basel) 2023;11(8):189.
doi:10.3390/dj11080189
12. Wani SA, Rabah SM, Alfadil S, Dewanjee N, Najmi Y.
Efficacy of communication amongst staff members at plastic
and reconstructive surgery section using smartphone and
mobile WhatsApp. Indian J Plast Surg 2013;46(3):502-5.
doi:10.4103/0970-0358.121990
13. Fernández CE, Maturana CA, Coloma SI, Carrasco-
Labra A, Giacaman RA. Teledentistry and mHealth for
promotion and prevention of oral health: a systematic
review and meta-analysis. J Dent Res 2021;100(9):914-27.
doi:10.1177/00220345211003828
14. Toniazzo MP, Nodari D, Muniz F, Weidlich P. Effect of mHealth
in improving oral hygiene: a systematic review with metaanalysis.
J Clin Periodontol 2019;46(3):297-309. doi:10.1111/
jcpe.13083
15. Von Helde NM, Martins ML, da Costa Motta M, de Souza TF,
Magno MB, Maia LC, et al. Are educational tools in oral health
programs for pregnant women effective in improving the oral
status of mothers and babies? A systematic review. Evid Based
Dent 2024;25(4):216. doi:10.1038/s41432-024-01043-1
16. McGrath C. Behavioral sciences in the promotion
of oral health. J Dent Res 2019;98(13):1418-24.
doi:10.1177/0022034519873842
17. Albino J, Tiwari T. Preventing childhood caries: a review of
recent behavioral research. J Dent Res 2016;95(1):35-42.
doi:10.1177/0022034515609034
18. Zolfaghari M, Shirmohammadi M, Shahhosseini H, Mokhtaran
M, Mohebbi SZ. Development and evaluation of a gamified
smart phone mobile health application for oral health promotion
in early childhood: a randomized controlled trial. BMC Oral
Health 2021;21(1):18. doi:10.1186/s12903-020-01374-2
19. Sarwer-Foner SN, Barasuol JC, Vieira RS. Impact of social
media on the oral hygiene habits of children and adolescents: a
randomized controlled clinical trial. Gen Dent 2021;69(1):70-6.
20. Shirmohammadi M, Razeghi S, Shamshiri AR, Mohebbi
SZ. Impact of smartphone application usage by mothers in
improving oral health and its determinants in early childhood:
a randomised controlled trial in a paediatric dental setting. Eur
Arch Paediatr Dent 2022;23(4):629-39. doi:10.1007/s40368-
022-00731-9
21. Babaei A, Pakdaman A, Hessari H, Shamshiri AR. Oral health
of 6-7 year-old children according to the Caries Assessment
Spectrum and Treatment (CAST) index. BMC Oral Health
2019;19(1):20. doi:10.1186/s12903-018-0709-x
22. Silness J, Loe H. Periodontal disease in pregnancy II. Correlation
between oral hygiene and periodontal condition. Acta Odontol
Scand 1964;22:121-35. doi:10.3109/00016356408993968
23. Loe H, Silness J. Periodontal disease in pregnancy I.
Prevalence and severity. Acta Odontol Scand 1963;21:533-
51. doi:10.3109/00016356309011240
24. Pouradeli S, Rad M, Shahravan A, Hashemipour MA, Rezaeian
M. Effect of different methods of education on oral health in
children with hearing impairment: a systematic review. J Oral
Health Oral Epidemiol 2019;8(2):55-60. doi:10.22122/johoe.
v8i2.329
25. Chen J, Wang Y. Social media use for health purposes:
systematic review. J Med Internet Res 2021;23(5): e17917.
doi:10.2196/17917
26. Almarshad M, Dhahi B, Alghanim O, Zaid M, Alfawwaz M,
AlSaffan A, et al. Parental oral health education through social
media and its impact on oral health of children. Ann Dent Spec
2021;9(2):7-10. doi:10.51847/Yp18Y1rVoH
27. Ribeiro YJ, Ferreira LG, Nelson-Filho P, Arnez MF, Paula-Silva
FW. Influence of digital media in the oral health education of
mother-child pairs: study protocol of a parallel double-blind
randomized clinical trial. Trials 2022;23(1):639. doi:10.1186/
s13063-022-06602-4
28. Almoddahi D, Machuca Vargas C, Sabbah W. Association of
dental caries with use of internet and social media among 12
and 15-year-olds. Acta Odontol Scand 2022;80(2):125-30. do
i:10.1080/00016357.2021.1951349
29. Shah N, Mathur VP, Kathuria V, Gupta T. Effectiveness of
an educational video in improving oral health knowledge
in a hospital setting. Indian J Dent 2016;7(2):70-5.
doi:10.4103/0975-962x.184646
30. Palin-Palokas T, Nordblad A, Remes-Lyly T. Video as a medium
of oral health education for children with mental handicaps. Spec
Care Dentist 1997;17(6):211-4. doi:10.1111/j.1754-4505.1997.
tb00899.x
31. Scribante A, Gallo S, Bertino K, Meles S, Gandini P, Sfondrini
MF. The effect of chairside verbal instructions matched with
Instagram social media on oral hygiene of young orthodontic
patients: a randomized clinical trial. Appl Sci 2021;11(2):706.
doi: https://doi.org/10.3390/app11020706
Journal of Oral Health and Oral Epidemiology
Volume 15
Pages 1-7

Files

History

  • Receive Date: 11 October 2025
  • Revise Date: 17 February 2026
  • Accept Date: 11 August 2026

Share

How to cite

Statistics