The relationship between parental mental health and early childhood caries: a meta-analysis and systematic review

OBJECTIVES: This study aimed to systematically evaluate the relationship between parental mental health and early childhood caries (ECC), providing scientific basis for researching the etiology and enabling clinical prediction and prevention of ECC. MATERIALS AND METHODS: A comprehensive search was conducted across five databases to identify relevant studies published up to October 2025. Eligible studies were those investigating the relationship between parental mental health and ECC. Data extraction and synthesis were performed following PRISMA guidelines using Stata 16.0. Robustness, heterogeneity, certainty of evidence, and publication bias were evaluated. RESULTS: Out of 2889 studies, 12 were included in the meta-analysis. From 12 included studies, 3 explored parental depression, 7 explored parental dental anxiety, 4 explored parental stress, and 1 explored parental general anxiety disorder. The meta-analysis results showed that parental mental conditions increased the risk of ECC (ECC prevalence rate: OR = 1.54, 95%CI: 1.12-2.12) and (dmft: SMD = 0.19, 95%CI: 0.13-0.26), significantly.The subgroup results showed that parental dental anxiety and depression were both associated with ECC (OR = 1.59, 95% CI: 1.00-2.51; OR = 1.49, 95% CI: 1.09-2.04). There was no relationship between parental stress and ECC (OR = 2.19, 95%CI: 0.36-13.20). The meta-analysis results of adjustment ORs about parental stress were similar to the crude ORs (OR = 0.81, 95%CI: 0.58-1.14). CONCLUSIONS: The results indicated a strong association between parental mental conditions and ECC. Furthermore, higher levels of dental anxiety and depression in parents were associated with a higher prevalence of ECC in their children. However, the relationship between psychological stress and ECC was not observed. Results must be interpreted with caution due to the limitations of the evidence base.