Parental Knowledge, Attitude and Practices Regarding Oral Health in Children Under 6 Years of Age
Keywords:
Parental knowledge, Attitude, Practices, Oral health, Early childhood cariesAbstract
Background: Early childhood caries is a prevalent chronic condition among young children, heavily influenced by parental knowledge, attitudes, and behaviors. Assessing these factors is vital for designing effective preventive strategies in primary dental care.
Objectives: To evaluate parental knowledge, attitudes, and practices (KAP) related to oral health in children under 6 years of age and to analyze the interrelationships among these domains.
Methods: A cross-sectional survey was conducted from May to July 2025 at a tertiary care hospital in India. One hundred and fifty parents of children aged 6 months to 6 years were enrolled consecutively from the pediatric outpatient department. A prevalidated 25-item questionnaire assessed knowledge (10 items; score 0–10, adequate ≥7), attitude (8 statements on a 5-point Likert scale; score 8–40, positive ≥32), and practices (7 questions on hygiene and dietary habits). Scores were summarized as mean ± SD or percentages. Pearson’s correlation tested associations between KAP domains. Statistical significance was set at p ≤ 0.05.
Results: Participants had a mean age of 29.8 ± 5.4 years; 72% were mothers. The mean knowledge score was 7.1 ± 1.8, with 68% achieving adequate knowledge. The mean attitude score was 34.2 ± 3.6, and 74% exhibited a positive attitude toward preventive oral care. Practice assessment revealed that 81% assisted their child with toothbrushing twice daily, while only 28% had arranged a dental visit by age 2. The mean practice index was 5.2 ± 1.1. Knowledge correlated positively with practice (r = 0.35, p < 0.001) and attitude (r = 0.42, p < 0.001); attitude also correlated with practice (r = 0.29, p = 0.002).
Conclusion:While most parents demonstrated moderate knowledge and positive attitudes toward their children’s oral health, gaps remain in early professional dental care and consistent hygiene practices. Targeted educational interventions are recommended to bridge these gaps and promote optimal oral health behaviors
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Naidu RS, Nunn JH. Oral Health Knowledge, Attitudes and Behaviour of Parents and Caregivers of Preschool Children: Implications for Oral Health Promotion. Oral Health Prev Dent. 2020 Jul 4;18(2):245-252. doi: 10.3290/j.ohpd.a43357. PMID: 32618448; PMCID: PMC11654493.
Chen L, Hong J, Xiong D, Zhang L, Li Y, Huang S, Hua F. Are parents' education levels associated with either their oral health knowledge or their children's oral health behaviors? A survey of 8446 families in Wuhan. BMC Oral Health. 2020 Jul 11;20(1):203. doi: 10.1186/s12903-020-01186-4. PMID: 32652985; PMCID: PMC7353758.
Alyahya L. Parental knowledge and practices regarding their children's oral health in Kuwait. Eur J Paediatr Dent. 2016 Dec;17(4):267-273. PMID: 28045313.
Tian J, Lim J, Moh F, Siddiqi A, Zachar J, Zafar S. Parental and training coaches' knowledge and attitude towards dental trauma management of children. Aust Dent J. 2022 Mar;67 Suppl 1(Suppl 1):S31-S40. doi: 10.1111/adj.12913. Epub 2022 May 17. PMID: 35510930; PMCID: PMC9790494.
Pan N, Cai L, Xu C, Guan H, Jin Y. Oral health knowledge, behaviors and parental practices among rural-urban migrant children in Guangzhou: a follow-up study. BMC Oral Health. 2017 Jun 7;17(1):97. doi: 10.1186/s12903-017-0385-2. PMID: 28592239; PMCID: PMC5461744.
Salama F, Alwohaibi A, Alabdullatif A, Alnasser A, Hafiz Z. Knowledge, behaviours and beliefs of parents regarding the oral health of their children. Eur J Paediatr Dent. 2020 Jun;21(2):103-109. doi: 10.23804/ejpd.2020.21.02.03. PMID: 32567940.
Aljafari A, ElKarmi R, Nasser O, Atef A, Hosey MT. Oral health status and practices of 6- to 7-year-old children in Amman, Jordan: a cross-sectional study. BMC Oral Health. 2022 Jul 25;22(1):307. doi: 10.1186/s12903-022-02342-8. PMID: 35879792; PMCID: PMC9310399.
Garrocho-Rangel A, López-Torre ME, Santos-Díaz MÁ, Torre-Delgadillo G, Flores-Arriaga JC, Saadia M, Pozos-Guillén A. Assessment of Pediatricians' Knowledge, Practices, and Attitudes on Oral Health/Care in Children in the Last Decade: A Systematic Scoping Review and Critical Reflection. J Clin Pediatr Dent. 2022 Jul 1;46(4):262-272. doi: 10.22514/1053-4625-46.4.2. PMID: 36099234.
Kumar G, Dhillon JK, Vignesh R, Garg A. Knowledge, attitude, and practical behavior of parents regarding their child's oral health in New Delhi. J Indian Soc Pedod Prev Dent. 2019 Jan-Mar;37(1):3-7. doi: 10.4103/JISPPD.JISPPD_257_18. PMID: 30804300.
Mahat G, Bowen F. Parental Knowledge about Urban Preschool Children’s Oral Health Risk. Pediatr Nurs. 2017 Jan-Feb;43(1):30-4. PMID: 29406664.
Alshemari MA, Alkandari SA. Oral Health Knowledge and Attitudes Towards Oral Health Education Among Elementary School Teachers in Kuwait. Oral Health Prev Dent. 2021 Nov 5;19:595-602. doi: 10.3290/j.ohpd.b2259111. PMID: 34734519; PMCID: PMC11641300.
Mishra A, Pandey RK, Chopra H, Arora V. Oral health awareness in school-going children and its significance to parent's education level. J Indian Soc Pedod Prev Dent. 2018 Apr-Jun;36(2):120-124. doi: 10.4103/JISPPD.JISPPD_1172_17. PMID: 29970627.
Tahani B, Asgari I, Golkar S, Ghorani A, Hasan Zadeh Tehrani N, Arezoo Moghadam F. Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran. BMC Oral Health. 2022 Dec 12;22(1):599. doi: 10.1186/s12903-022-02644-x. PMID: 36510207; PMCID: PMC9744048.
Sehrawat P, Shivlingesh KK, Gupta B, Anand R, Sharma A, Chaudhry M. Oral health knowledge, awareness and associated practices of pre-school children's mothers in Greater Noida, India. Niger Postgrad Med J. 2016 Jul-Sep;23(3):152-7. doi: 10.4103/1117-1936.190344. PMID: 27623728.
Vallés A, Lluch C, Munné C, Veloso A, Paglia L, Guinot F. Comparison of knowledge between Italian and Spanish parents about the oral health of their preschool children. Eur J Paediatr Dent. 2022 Sep;23(3):194-200. doi: 10.23804/ejpd.2022.23.03.05. PMID: 36172910.
Alanzi A, Muhammad S, Faridoun A, Alterkait A. Pediatricians' Knowledge of Children's Oral Health: A National Survey. Int Dent J. 2023 Jun;73(3):463-469. doi: 10.1016/j.identj.2022.08.004. Epub 2022 Sep 15. Retraction in: Int Dent J. 2024 Apr;74(2):364. doi: 10.1016/j.identj.2024.03.001. PMID: 36116980; PMCID: PMC10213804.
Acharya S, Acharya S, Mahapatra U. Knowledge, attitudes, and practices among gynecologists regarding oral health of expectant mothers and infants in Bhubaneswar City, Odisha. J Indian Soc Pedod Prev Dent. 2018 Jul-Sep;36(3):240-243. doi: 10.4103/JISPPD.JISPPD_27_18. PMID: 30246743.
Alkhubaizi Q, Moule A, Al-Sane M, Sorkin JD. Oral health practices and knowledge among parents and hired caregivers. Eur Arch Paediatr Dent. 2018 Dec;19(6):403-410. doi: 10.1007/s40368-018-0372-6. Epub 2018 Oct 12. PMID: 30315536.
Davidović B, Ivanović M, Janković S, Lečić J. Knowledge, attitudes and behavior of children in relation to oral health. Vojnosanit Pregl. 2014 Oct;71(10):949-56. PMID: 25518275.
Varkey IM, Ghule KD, Mathew R, Desai J, Gomes S, Mudaliar A, Bhori M, Tungare K, Gharat A. Assessment of attitudes and practices regarding oral healthcare during the COVID-19 pandemic among the parents of children aged 4-7 years. Dent Med Probl. 2022 Jul-Sep;59(3):365-372. doi: 10.17219/dmp/147184. PMID: 36166292.
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