{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:06:35Z","timestamp":1791839195478,"version":"4.3.4"},"reference-count":34,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Chinese Medical Scientific Research Foundation of Zhejiang Province","award":["2024ZL928"],"award-info":[{"award-number":["2024ZL928"]}]},{"name":"Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Ningbo, Zhejiang, China","award":["2019E10020"],"award-info":[{"award-number":["2019E10020"]}]},{"name":"Project of NINGBO Leading Medical & Health Discipline","award":["2022-F20"],"award-info":[{"award-number":["2022-F20"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,12]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"\n Objectives<\/jats:title>\n This study aimed to explore the relationship between oral health and the knowledge, attitudes and practices (KAP) of parents and teachers of kindergarten students towards oral health.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This web-based cross-sectional survey was conducted in Ningbo City from February 2023 to March 2023.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The study targets parents and teachers of kindergarten students in Ningbo City (five kindergartens selected using convenience sampling). The research aimed to explore the relationships between oral health practices, knowledge and attitudes among parents and teachers.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n A total of 540 valid questionnaires were collected from parents and teachers. Clear definitions of selection, entry and exclusion criteria were followed to ensure comprehensive data collection.<\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n Assessment of oral health KAP among parents and teachers and correlation between KAP levels and students\u2019 oral hygiene habits.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Key findings include comparatively high levels of oral health knowledge among parents (7.29\u00b11.74), positive attitudes towards oral health (23.69\u00b12.97), and commendable practices (51.92\u00b14.76). The structural equation model suggested a direct positive influence of attitude (\u03b2=0.27, p<0.001) and knowledge (\u03b2=0.51, p<0.001) on practice. Daily habits were also influenced indirectly by both attitude (\u03b2=0.10, p<0.001) and knowledge (\u03b2=0.20, p<0.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The study underscores the significant effect of parents\u2019 and teachers\u2019 KAP on kindergarten students\u2019 oral health. The unknown representativeness of the sample necessitates caution in generalisation; nonetheless, the findings highlight the importance of enhancing oral health education and implementing targeted interventions to improve hygiene practices, with the potential to decrease dental caries prevalence among children. Collaborative efforts are essential in promoting effective oral health practices among young populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089404","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T05:30:13Z","timestamp":1750224613000},"page":"e089404","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Knowledge, attitude and practice towards oral health in parents and teachers of kindergarten students: a cross-sectional survey"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9520-6113","authenticated-orcid":false,"given":"Liang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jijun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyuan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danhua","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"2025120517595639000_15.6.e089404.1","doi-asserted-by":"crossref","DOI":"10.3390\/nu12092619","article-title":"Eating Habits and Their Relationship to Oral Health","volume":"12","author":"Tenelanda-L\u00f3pez","year":"2020","journal-title":"Nutrients"},{"key":"2025120517595639000_15.6.e089404.2","article-title":"Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations","volume":"9","author":"Butera","year":"2022","journal-title":"Children (Basel)"},{"key":"2025120517595639000_15.6.e089404.3","doi-asserted-by":"publisher","DOI":"10.4103\/ijdr.IJDR_805_18"},{"key":"2025120517595639000_15.6.e089404.4","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.953545","article-title":"The effect of unhealthy dietary habits on the incidence of dental caries and overweight\/obesity among Egyptian school children (A cross-sectional study)","volume":"10","author":"Mahmoud","year":"2022","journal-title":"Front Public Health"},{"key":"2025120517595639000_15.6.e089404.5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1159\/000481414","article-title":"Redefining the Phenotype of Dental Caries","volume":"52","author":"Weber","year":"2018","journal-title":"Caries Res"},{"key":"2025120517595639000_15.6.e089404.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-022-02644-x","article-title":"Effectiveness of an integrated model of oral health-promoting schools in improving children\u2019s knowledge and the KAP of their parents, Iran","volume":"22","author":"Tahani","year":"2022","journal-title":"BMC Oral Health"},{"key":"2025120517595639000_15.6.e089404.7","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0528.2003.00010.x"},{"key":"2025120517595639000_15.6.e089404.8","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1177\/1359104521999762","article-title":"Parental autonomy support in relation to preschool aged children\u2019s behavior: Examining positive guidance, negative control, and responsiveness","volume":"26","author":"Linkiewich","year":"2021","journal-title":"Clin Child Psychol Psychiatry"},{"key":"2025120517595639000_15.6.e089404.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-020-01186-4","article-title":"Are parents\u2019 education levels associated with either their oral health knowledge or their children\u2019s oral health behaviors? 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