BACKGROUND: Moral principles in children can influence their oral hygiene practices and can be beneficial in providing better oral health care. AIM: To assess the consistency of Piaget's moral development principles in Indian children aged 7 to 11 years and evaluate its influence on their oral hygiene practices. DESIGN: The first phase of the embedded mixed-method approach included telephone interviews of 50 children on eight situations of moral development as suggested by Jean Piaget. Children were categorised into heteronomous and autonomous moralities based on the content analysis. The second phase of the study included a semi-structured qualitative interview on knowledge and practice behaviour of children on oral hygiene maintenance. RESULTS: There was no significant difference in the overall moral development of children aged 7 to 9 years and 9 to 11 years (p = .57). Only 4.8% of girls had heteronomous morality, and a significant difference was noted between boys and girls (p = .014). There was a significant difference in the oral hygiene practices observed between heteronomous morality and autonomous morality children. CONCLUSION: Children were autonomous in their morality at 7 to 9 years of age. Children with autonomous morality performed better oral hygiene practices than children with heteronomous morality.
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