Knowledge, Attitude, and Practice of Parents on Sugar Consumption in Children with and without Early Childhood Caries: A Cross-sectional Study

Abstract Introduction: Early childhood caries (ECC) is a multifactorial disease strongly influenced by frequent sugar consumption and poor dietary practices. Parents, as the primary caregivers, are instrumental in guiding and shaping their children’s dietary habits, which directly impact their oral health. Aim: This study examines differences in parental knowledge, attitudes, and practices (KAP) regarding sugar consumption between children with and without ECC, identifying areas for intervention. Methods: A cross-sectional survey was carried out among parents of 3-to 5-year-old children attending the outpatient department. The relevant data were obtained using a prevalidated self-administered questionnaire for assessing parental KAP related to sugar consumption and a 24-h dietary recall chart to calculate sweet scores. The Chi-square test and linear regression were used to analyze the associations between the variables. Results: Significant differences were observed between ECC and non-ECC groups. Parents of children experiencing ECC more frequently added sugar to milk 2–3 times daily and provide flavored chocolate powders more frequently. Ultraprocessed food consumption was higher in ECC children, with only 55% of their parents acknowledging its role in tooth decay compared to 83% in the non-ECC group. Fruit consumption was significantly lower in ECC children. Conclusion: The findings highlight gaps in parental KAP, particularly regarding frequent sugar and high intake of synthetic food products, which are associated with a higher prevalence of ECC in children.