Parental knowledge, attitudes, and practices regarding malocclusion in preschool children

This cross-sectional study aimed to assess the knowledge, attitudes, and practices (KAP) of parents regarding malocclusion in preschool-aged children in Nanchong City, Sichuan Province, between January and July 2024. Data were collected via questionnaires to gather demographic information and assess parents' KAP, with univariable and multivariable logistic regression analyses used to explore the associations between demographic factors and KAP. Structural equation modeling (SEM) was applied to investigate complex relationships among relevant factors. A total of 2811 valid cases were included, of which 61.2% were female. The mean scores for knowledge, attitude, and practice were 3.71, 26.50, and 40.98, respectively. Positive correlations were found between knowledge and attitude (r = 0.491), knowledge and practice (r = 0.275), and attitude and practice (r = 0.336). SEM revealed that knowledge had a direct effect on both attitude (β = 0.509) and practice (β = 0.204), while attitude also directly influenced practice (β = 0.176). Knowledge indirectly impacted practice through attitude (β = 0.090). Parents showed inadequate knowledge and generally negative attitudes but positive practices. Educational interventions are recommended to improve parental knowledge and attitudes, which may lead to better malocclusion management practices.