Association of Parental Oral Health Knowledge and Self-Efficacy with Early Childhood Caries and Oral Health Quality of Life in Texas Schoolchildren

Improving children's oral health is a national priority. Parental knowledge and self-efficacy influence children's health behaviors; however, the relationship between parental oral health-related knowledge, self-efficacy, child oral health-related quality of life (OHQoL), and dental caries remains unclear, especially among low-income, ethnically diverse U.S. families. This study assesses the relationship between parental oral health-related knowledge, self-efficacy, child dental caries, and OHQoL. This cross-sectional seco ndary analysis uses baseline data from a school-based cluster-randomized controlled trial among children (kindergarten-second grade). Dental assessments were conducted using the International Caries Detection and Assessment System (ICDAS) on site in schools at baseline (n = 34 schools, n = 1084 consenting parent-child dyads). Child OHQoL, parental knowledge, and self-efficacy were measured using validated self-report surveys. Associations between exposures and outcomes (child dental caries prevalence, child OHQoL) were evaluated by univariate and multivariable logistic and linear regressions, respectively. After adjusting for covariates, higher parental self-efficacy was associated with lower child OHQoL (lower score indicates higher quality of life) [beta = -0.16, 95% CI: -0.24, -0.09, <i>p</i> < 0.01] and lower odds of active dental caries [Adj OR: 0.95, 95% CI: 0.9, 0.99, <i>p</i> = 0.02]. No significant associations were noted for parental knowledge. These findings can inform future research, understanding how parental psychosocial factors influence dental caries prevention behaviors and risk, and inform interventions for children.