Objectives: In Iran, few studies have been conducted on children’s oral and dental indices and the effect of mothers’ oral health literacy on these indices. This study was conducted with the aim of determining the level of mothers’ oral health literacy (OHL) in relation to the oral health status of children attending dental clinics, compared to comprehensive health services. Methods: In this cross-sectional study conducted in Iran, we examined the oral health of 436 children aged 3–12 and their mothers. The study utilized the WHO’s pathway model and the Fisher-Owens framework to assess structural, intermediate, and direct factors influencing oral health. Data were collected through clinical examinations and interviews, focusing on demographics, oral health literacy (Adult Oral Health Literacy Questionnaire), and behaviors (Children’s Oral Health Behavior Questionnaire). Results: The dental health assessment indicated moderate levels of decayed, missing, and filled teeth, affecting 42.6% of individuals in comprehensive health services and 45.7% in dental clinics. In both groups, children’s oral health behavior improved with older siblings, age, and a smaller household size (p < 0.05). In dental clinics, higher maternal oral health literacy was linked to a lower incidence of dental issues (IRR = 0.73, p = 0.007). Children of mothers with higher education exhibited a lower incidence rate of dental problems compared to those with housewife mothers (IRR = 0.75, p = .001). Additionally, moderate oral health behavior in children correlated with a reduced incidence of dental issues compared to poor oral health behavior (IRR = 0.50, p = .001). Conclusions: The study’s findings indicate that higher maternal oral health literacy is positively associated with improved oral health in children. This underscores the significance of educational initiatives designed to enhance mothers' understanding of oral health, ultimately contributing to better dental health outcomes for their children.
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