Oral health in childhood is foundational to overall well-being and affects eating, speaking, and social functioning. Dental caries is a common, preventable chronic disease among children worldwide, and early prevention is essential to avoid lasting consequences. Parents are central to establishing oral hygiene routines, encouraging healthy diets, and arranging routine dental care; parental monitoring, literacy, knowledge, and attitudes strongly influence children’s oral health behaviours and access to services.
Immigrant families commonly face geographic, economic, linguistic, and system-navigation barriers that can limit access to preventive care and oral health education. Such stressors may erode initial health advantages observed among newcomers and contribute to higher risk of untreated dental conditions among first-generation immigrant children in Canada.
Contemporary parenting occurs within digitally mediated environments. For immigrants, platforms such as Facebook, WhatsApp, WeChat, and YouTube serve as infrastructures for maintaining transnational ties, seeking parenting information, and accessing community support. While social media can aid cultural adaptation and reduce stress, excessive use or dependence—often framed as social media addiction—may reinforce isolation, increase parental stress, or interfere with parent–child interactions (a concept described as technoference). Parental anxiety and depression can further impair caregiving capacity and thereby influence children’s health behaviours, including oral hygiene and dental service use.
This study investigated whether maternal mental health (anxiety, depression) is associated with children’s oral health behaviours, and whether social media addiction mediates or moderates these associations in an immigrant population.
A cross-sectional observational study was conducted in Edmonton, Alberta, Canada, between 2021 and 2024. Ethical approval was obtained from the University of Alberta Health Research Ethics Board (Pro00112790). The sample comprised immigrant parents of children aged 2–12 years. Parents completed a questionnaire capturing demographics, children’s oral health behaviours (dental visits, toothbrushing, diet), maternal anxiety and depression assessed with the Hospital Anxiety and Depression Scale (HADS-14; scored 0–21), and social media addiction measured with the Bergen-6 scale (scored 6–30).
Statistical analyses included logistic regression to examine associations between maternal mental health measures and categorical child oral health outcomes, and mediation and moderation analyses to test whether social media addiction accounted for or altered those associations. The study analyzed 302 completed questionnaires.
Sample characteristics included a maternal mean age of 37.7 years (SD 6.8) and child mean age of 6.7 years (SD 3.3). Of children, 49% were female and 65% were born in Canada. Parents had lived in Canada an average of 9.9 years; 68% reported higher education.
Higher maternal anxiety was associated with reduced odds of child toothbrushing: each one-unit increase in anxiety was linked to a 14% reduction in the odds of child toothbrushing (OR 0.86, 95% CI 0.74–0.98). Higher maternal depression showed a similar association: each one-unit increase corresponded to a 21% reduction in the odds of child toothbrushing (OR 0.79, 95% CI 0.63–0.93).
Maternal anxiety and depression were also positively associated with higher social media addiction scores; the report indicates that each one-unit increase in anxiety and depression corresponded to increases in social media addiction (reported as approximately 49% and 51% increases, respectively; p < .05).
Mediation and moderation analyses did not support a mediating or moderating role for social media addiction in the observed relationships between maternal mental health and children’s oral health behaviours. In other words, while maternal anxiety and depression related to higher social media addiction scores, social media addiction did not explain or alter the link between maternal mental health and reduced child toothbrushing in this sample.
Findings indicate that maternal anxiety and depression are associated with lower likelihood of regular toothbrushing among children of immigrant families in this study. Although higher maternal anxiety and depression were linked to greater social media addiction scores, the anticipated pathway whereby social media addiction would mediate or moderate the influence of maternal mental health on children’s oral health behaviours was not supported.
These results align with literature identifying parental mental health as a determinant of children’s health behaviours and highlight the particular vulnerabilities that immigrant families can face. The lack of mediation or moderation by social media addiction suggests that the relationship between maternal mental health and children’s toothbrushing may operate through other caregiving or structural mechanisms not captured by the Bergen-6 measure or the study’s cross-sectional design.
In this immigrant sample, maternal anxiety and depression were associated with reduced child toothbrushing, and social media addiction did not mediate or moderate these associations. The authors recommend integrating mental health screening into dental care for immigrant communities as a strategy to identify and address underlying psychosocial barriers to preventive oral health behaviours. Embedding mental health supports within oral health services may foster better outcomes and contribute to more inclusive policies.
The study used a cross-sectional design, which limits causal inference. Details on recruitment, response rates, and potential sampling bias are reported in the full article but were not reproduced here in full. Future research should consider longitudinal designs to clarify causal pathways, explore additional mediators or contextual factors linking parental mental health to children’s oral health, and test interventions that integrate mental health screening with preventive dental care for immigrant populations.