Abstract
BACKGROUND: Oral health is an essential component of overall well-being. Despite ongoing public health education efforts, childhood dental caries remain highly prevalent in Indonesia, particularly in resource-limited school settings. Teachers play a strategic role as change agents in shaping children's oral health knowledge, attitudes, and behaviors; however, their capacity to deliver effective oral health education is often underdeveloped. This study evaluated the impact of multimedia-assisted training and microteaching on teachers' facilitation, and its subsequent effect on students' oral health status and oral health-related knowledge, attitudes, and behaviors. METHODS: A mixed-methods sequential explanatory design was employed involving 582 primary school students and 16 teachers from public elementary schools in Pohuwato District, Gorontalo Province, Indonesia. Teachers were allocated into two intervention groups: (1) multimedia training combined with microteaching (n = 8) and (2) multimedia training only (n = 8). Students' oral health outcomes were assessed over a six-month period using the Decayed, Missing, and Filled Teeth (DMFT) index and the Oral Hygiene Index Simplified (OHI-S). Teachers' knowledge, attitudes, and practices were evaluated using validated questionnaires. Qualitative data were collected through focus group discussions with teachers in the multimedia + microteaching group. RESULTS: Both intervention groups demonstrated significant improvements in students' OHI-S and DMFT scores (p < 0.05), with the multimedia + microteaching group showing superior outcomes. Teachers' knowledge and instructional performance improved significantly following the intervention (p < 0.01). Qualitative findings indicated that microteaching enhanced teachers' confidence, consistency, and creativity in delivering oral health education, contributing to more sustained behavioral change among students. CONCLUSION: Integrating multimedia training with microteaching strengthens teachers' pedagogical competence and leads to measurable improvements in students' oral hygiene and oral health-related behaviors. This school-based approach offers a replicable and scalable model for oral health promotion in low-resource educational settings.