Art and Puppets as Educational Tool for Diet Counseling among 4 to 6-year-old Children: A Quasi-experimental Study

mode of health communication plays a vital role in influencing behavior change, particularly in younger age-groups.10 Among these, puppetry has shown promise in educational and therapeutic settings; yet, its application in structured dental health interventions remains underexplored.9,10 IntroductIonGlobally, approximately 530 million children are affected by dental caries in their primary dentition, reflecting a profound public health concern in pediatric populations. 1 Childhood and adolescence are pivotal periods for establishing lifelong oral health, as dental diseases, such as caries, are not only progressive and cumulative but also significantly impact quality of life. 2 Despite this, low utilization of dental services persists, often due to low perceived need rather than the absence of symptoms.3,4 Many children, especially those without prior dental visits, overestimate their oral health status and remain disengaged from preventive care.5 Early preventive education is crucial for modifying these perceptions.As preschoolers gain increasing access to sugar-rich foods, timely interventions can reduce caries risk and promote healthier dietary patterns.6 In this context, oral health education emerges as a powerful tool, especially when delivered in engaging and age-appropriate formats.7 Schools offer an ideal platform for such health promotion efforts, given their structured environment and access to young learners.8 Moreover, early school-age interventions have the potential to instill attitudes and behaviors that persist into adulthood.9 While traditional oral health education has relied on lectures or printed materials, emerging strategies now incorporate interactive methods, such as puppetry, art, and storytelling to capture children's attention and improve retention.10