The results of this study highlight the relationship between dental caries in children aged 3–5 years and their parents’ KAP regarding their children’s oral health. The oral health of children aged 3–5 years is primarily the responsibility of their parents, which indicates that the main cause of dental caries in children is insufficient KAP among parents regarding their children’s oral health. Parents' KAP is formed through the influence of many factors. There is a correlation between the parents’ education level and the time and energy they devote to acquiring oral-health knowledge. Additionally, the associated harms, the pathogenic factors, the treatment, and especially the prevention of dental caries are the oral-health topics for which parents lack sufficient knowledge. In short, parents are mindful of their children’s oral health, but show some deficiencies regarding their practices for protecting their children’s oral health.
Parents’ education levels influence the number of dental caries their children have. Parents are an important resource of oral-health knowledge for children, and their associated KAP affects their children’s formation of oral-health concepts. Previous studies have also focused on the relationship between parents’ education levels and their children’s oral health awareness,15 and studies have shown that, by improving their knowledge and attitude towards oral health, parents can improve their children’s oral health.16 During the preschool period, parents are the primary persons responsible for their children’s oral health, so parents should acquire sufficient oral-health knowledge and implement relevant oral-health-promotion activities to control their children’s oral-health risks.17
UK-based researchers have suggested that, to protect children’s oral health, “health visitors” (i.e., public-health nurses) should receive training in oral-health promotion, including how to perform oral-health risk assessments and guidance on evidence-based, up-to-date prevention measures.18 On the other hand, in the US the “dental home” has been developed to foster a comprehensive, sustained, coordinated, family-centered approach to providing oral-health care among children.19 The success of this initiative should be noted, and similar approaches should be considered in other countries. Such as, under the guidance of province-level, city-level and county-level centers for disease control and prevention in China, Chinese community health service centers or service stations have established corresponding dental homes or similar organizations.20
In Beijing, parents’ KAP regarding their children’s oral health is improving, and they are paying more attention to their children’s oral health.21 The respondents of the present study showed high awareness of basic oral-health knowledge. There are several possible reasons for this. First, the economy, politics, and society in Beijing are relatively stable, and the development of public-health services related to oral health is relatively good. Second, public dissemination of health knowledge through social media can greatly enhance understanding of health knowledge among social groups.22 Individuals who are seeking information about oral health can search the Internet for health information or consult an online health expert. Finally, parents’ health awareness is increasing and they have more knowledge about the management of children's oral health. Therefore, among parents’ KAP, knowledge and attitudes are improving. However, the current situation, in which children of parents with adequate oral-health knowledge continue to experience oral diseases, indicates that parents’ oral-health-related actions, including supervision of children's brushing and educating children about proper brushing methods, require further analysis to better determine safeguarding measures for children’s oral health.
To protect their children’s oral health, parents must consider various factors, including food choices, dental cleaning, and dental replacement. Excessive consumption of sugar-rich foods in children increases the prevalence of dental caries.23 Sweets, cakes, and sweet drinks contain large amounts of sugar, and parents should limit children’s intake of such foods. However, parents continue to have difficulty controlling the consumption of sugar-rich foods in children. First, sugar-rich foods are attractive to humans.24 Second, parents can have busy work lives, meaning their ability to intervene in this regard is limited. Parents’ level of oral-health knowledge is relatively good. However, their demand for knowledge concerning dental-caries-related diseases is relatively high, indicating that they lack knowledge in certain areas. First, general oral-health knowledge is relatively easy to obtain, but elements concerning the dangers associated with dental caries, the treatment of dental caries, and the prevention of dental caries remain relatively restricted to professional dental knowledge. For instance, the effects of various saliva components, including ph, buffering capacity, proteins, electrolytes, antioxidants, enzymes and minerals, on the generation of dental caries are largely known only to medical professionals.25 Second, the high demand for knowledge indicates that regular oral examinations and contents and the correct methods of brushing teeth should be further publicized and explained by health-care organizations.
The respondents’ preferred sources of oral-health knowledge revealed a high demand for prescribed health education, doctor-patient exchanges, classroom education, educational videos, mobile- or web-based resources, and examples using teeth models. In contrast, return telephone calls and visiting treatment sites showed low demand. Therefore, to promote oral-health knowledge, the above knowledge sources should be adopted, and practical actions for improving people's awareness of oral health knowledge should be applied.26
Regular access to oral-health knowledge and accompanying children to examinations are factors that influence dental caries in children. Active learning and understanding of oral-health-related knowledge among parents are conducive to timely health interventions for children and guidance that protects children's teeth.27 Regular dental check-ups play a key role in maintaining oral health;18 thus, parents should insist on regularly accompanying children to hospitals or community medical institutions for dental check-ups. More importantly, countries should explicitly include dental examinations in their health-care plans.28
The results of this study only represent parents who have relatively high education levels and who are based in an economically developed city. It is important to note that there are several constraints regarding the findings. First, the research focused on a specific group, meaning the results are not completely generalizable. In future research, parents from less-developed areas or rural areas should be surveyed in order to compare the results. Second, there may be other problems (e.g., gum disease) that can better reflect the current situation of parents’ KAP regarding children's oral health. These problems can be incorporated into future research, thereby constructing a more comprehensive understanding of parents’ oral-health-related KAP. Finally, family economic status could be considered and compared with the frequency of dental exams, which could reveal additional factors that influence dental caries in children.