Early Childhood Oral Health: Insights into Knowledge, Preventive Practices, and Risk Awareness from a Croatian Cross-Sectional Study

<i>Aim:</i> Early childhood caries (ECC) is a widespread and multifactorial oral disease that affects children globally. Parents' knowledge, attitudes, and behaviors are crucial in preventing ECC and supporting oral health. This study evaluated Croatian parents' understanding of children's oral health, their awareness of ECC risk factors, and their oral hygiene practices. <i>Materials and methods:</i> A cross-sectional study was conducted using an anonymous and voluntary online questionnaire from October to December 2024 among 948 parents of children aged 1-7 years across Croatia. The study assessed parents' knowledge of oral health, their understanding of the relationship between risk factors and early childhood caries, habits related to oral hygiene care, children's experiences with oral health problems, parents' self-assessment of their knowledge, as well as both their own and their children's general and oral health and hygiene practices. Data were analyzed using descriptive statistics, Chi-square test, Mann-Whitney U test, and Kruskal-Wallis test. <i>Results:</i> Overall parental knowledge was moderate, with significantly higher scores among older parents, those with university education, healthcare workers, and families with higher incomes (<i>p</i> < 0.05). Parents demonstrated good awareness of the importance of supervising tooth brushing until age seven (93.8%) and fluoride use (81.8%); yet gaps persisted regarding bacterial transmission, tooth eruption, and early orthodontic evaluation. Preventive dental visits were frequently delayed, and only 25.0% of parents reported using interdental cleaning aids. Caries was the most common oral health issue among children (22.3%). <i>Conclusions:</i> Despite moderate awareness and some adherence to preventive measures, significant knowledge and practice gaps remain among Croatian parents. Targeted educational interventions and nationwide preventive strategies are necessary to strengthen oral health literacy and reduce ECC prevalence.