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Structured questionnaires were administered to collect demographic information and to evaluate participants\u2019 KAP scores related to periodontal health. A cutoff value of 70% of the maximum possible score was applied to define adequate knowledge, positive attitude, and proactive practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2,638 valid questionnaires were included in the final analysis. Among the respondents, 1,636 (62.02%) were female, with a mean age of 31.59\u2009\u00b1\u200910.44 years. A total of 1,853 participants (70.24%) were undergoing orthodontic treatment for the first time. The mean scores for KAP were 12.54\u2009\u00b1\u20093.94 (possible range: 0\u201318), 46.00\u2009\u00b1\u20094.13 (possible range: 10\u201350), and 39.30\u2009\u00b1\u20095.01 (possible range: 9\u201345), respectively. Structural equation modeling (SEM) demonstrated that knowledge was positively associated with attitude (\u03b2\u2009=\u20090.493,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and practice (\u03b2\u2009=\u20090.753,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and that attitude was positively associated with practice (\u03b2\u2009=\u20091.087,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). In addition, knowledge showed an indirect association with practice mediated by attitude (\u03b2\u2009=\u20090.535,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Orthodontic patients exhibited insufficient knowledge but maintained generally positive attitudes and proactive practices regarding periodontal health. These findings highlight the importance of understanding periodontal health literacy among orthodontic patients within a descriptive KAP framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08750-4","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:16:11Z","timestamp":1780488971000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Orthodontic patients\u2019 knowledge, attitude, and practice regarding periodontal health"],"prefix":"10.1186","volume":"26","author":[{"given":"Jing","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lande","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengnan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"8750_CR1","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1016\/S0140-6736(05)67728-8","volume":"366","author":"BL Pihlstrom","year":"2005","unstructured":"Pihlstrom BL, Michalowicz BS, Johnson NW. 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