{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:18:17Z","timestamp":1787944697790,"version":"build-2784847793"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"},{"id":[{"id":"https:\/\/ror.org\/00wzhv093","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Dental caries remains one of the most prevalent chronic diseases in childhood, influenced by a combination of hygiene, dietary, and access-related behaviours that are largely shaped by parental involvement. This study aimed to evaluate oral hygiene habits, dietary risk factors, access to dental services, awareness of caries prevention, and the impact of oral health on the child, in relation to parent-reported dental caries in Romanian children and adolescents. Methods: A cross-sectional study was conducted using a structured online questionnaire completed by parents or legal guardians of 508 children and adolescents aged under 18 years. Associations between categorical variables and reported caries were assessed using chi-square tests and Cram\u00e9r\u2019s V. Ordinal variables were compared using the Mann\u2013Whitney U test. A multivariable logistic regression identified independent predictors of reported caries, with robustness examined through sensitivity analyses. Results: Parent-reported caries was present in 61.2% of children. The strongest associations with caries were the absence of parental supervision during brushing (Cram\u00e9r\u2019s V = 0.364), the age at which children began brushing unsupervised (V = 0.354), and the reason for the last dental visit (V = 0.426). In the multivariable model, older age, absence of brushing supervision, sweets before bedtime, less frequent dental visits, and rural residence were independent predictors (all p &lt; 0.05; Nagelkerke R2 = 0.361). All six assessed dimensions of oral-health impact on the child were significantly associated with caries, with physical discomfort showing the largest effect (V = 0.349). Conclusions: Parent-reported caries risk in this population clustered around a small number of modifiable behaviours rather than any single dominant factor, while reported caries was associated with a substantial burden on children\u2019s daily functioning. These findings point to sustained parental supervision and routine, non-symptomatic dental care as priority targets for future prevention efforts, although intervention studies are needed to confirm their effectiveness.<\/jats:p>","DOI":"10.3390\/children13091154","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:47:13Z","timestamp":1787849233000},"page":"1154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parental Reports of Oral Health Behaviours and Dental Caries in Romanian Children and Adolescents: A Cross-Sectional Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9300-1367","authenticated-orcid":false,"given":"Darius Dacian","family":"Macavei","sequence":"first","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-3842","authenticated-orcid":false,"given":"Raluca","family":"Iurcov","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 4 Universit\u0103\u021bii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7275-9986","authenticated-orcid":false,"given":"Abel Emanuel","family":"Moca","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 4 Universit\u0103\u021bii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca Daniela","family":"Marton","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 1 Universitatii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1417-5963","authenticated-orcid":false,"given":"Gabriela","family":"Ciavoi","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 4 Universit\u0103\u021bii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ligia Lumini\u021ba","family":"Vaida","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 4 Universit\u0103\u021bii Street, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1111\/cdoe.12819","article-title":"Socioecological Determinants of Child Oral Health\u2014A Scoping Review","volume":"51","author":"Do","year":"2023","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_2","unstructured":"World Health Organization (2026, July 09). Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240061484."},{"key":"ref_3","unstructured":"World Health Organization (2026, July 09). Ending Childhood Dental Caries: WHO Implementation Manual, Available online: https:\/\/iris.who.int\/handle\/10665\/330643."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0140-6736(19)31133-X","article-title":"Ending the Neglect of Global Oral Health: Time for Radical Action","volume":"394","author":"Watt","year":"2019","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1093\/nutrit\/nuad147","article-title":"Impact of Unhealthy Food and Beverage Consumption on Children\u2019s Risk of Dental Caries: A Systematic Review","volume":"82","author":"Large","year":"2024","journal-title":"Nutr. Rev."},{"key":"ref_6","first-page":"118","article-title":"Free Sugars Consumption around Bedtime and Dental Caries in Children: A Systematic Review","volume":"3","author":"Baghlaf","year":"2018","journal-title":"JDR Clin. Trans. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100902","DOI":"10.1016\/j.identj.2025.100902","article-title":"Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study","volume":"75","author":"Chou","year":"2025","journal-title":"Int. Dent. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"33644","DOI":"10.1038\/s41598-025-13422-4","article-title":"Parental Health Belief and Behavioral Factors Influencing Oral Health Behaviors of Preschoolers in Shanghai: A Cross-Sectional Study","volume":"15","author":"Xu","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.22514\/jocpd.2024.074","article-title":"The Influence of Parental Oral Health Literacy on Children\u2019s Oral Health: A Scoping Review","volume":"48","author":"Alzahrani","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mousa, M., Alkandari, M., Alabbasi, H., Alhujailan, R., Bohamdi, K., Ahmad, L., Almatooq, A., Alsulimmani, W., and Alhazmi, H. (2026). Barriers to Dental Service Utilization in Children: A Systematic Review and Meta-Analysis. BMC Oral Health, 26.","DOI":"10.1186\/s12903-026-07890-x"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sabbagh, H.J., Albeladi, N.H., Altabsh, N.Z., and Bamashmous, N.O. (2023). Risk Factors Associated with Children Receiving Treatment at Emergency Dental Clinics: A Case-Control Study. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20021188"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Moca, A.E., \u021aig, I.A., Ciavoi, G., Iurcov, R., \u0218ipo\u0219, L.R., and Todor, L. (2022). The Impact of the COVID-19 Pandemic on the Dental Emergency Service from Oradea, Romania: A Retrospective Study. Healthcare, 10.","DOI":"10.3390\/healthcare10091786"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1159\/000345534","article-title":"Impact of Early Childhood Caries on the Oral Health-Related Quality of Life of Preschool Children and Their Parents","volume":"47","author":"Marques","year":"2013","journal-title":"Caries Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chimbinha, \u00cd.G.M., Ferreira, B.N.C., Miranda, G.P., and Guedes, R.S. (2023). Oral-Health-Related Quality of Life in Adolescents: Umbrella Review. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16241-2"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Moca, A.E., \u021aig, I.A., Chereche\u0219, J.O., Moca, R.T., and Iurcov, R. (2025). Impact of Marital Status, Education, and Family Size on Parental Behaviors Toward Early Childhood Caries in Romania. Dent. J., 13.","DOI":"10.3390\/dj13030111"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5116\/ijme.4dfb.8dfd","article-title":"Making Sense of Cronbach\u2019s Alpha","volume":"2","author":"Tavakol","year":"2011","journal-title":"Int. J. Med. Educ."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Castilho, G.T., Pessoa, M.N., de Oliveira, C.C., de Melo, L.S.A., Tagliaferro, E.P.S., and Pardi, V. (2025). Family Factors Associated with Dental Caries Among 5-Year-Old Preschool Children. Front. Dent. Med., 5.","DOI":"10.3389\/fdmed.2024.1473194"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/sj.ebd.6401283","article-title":"Beneficial Effects of Supervised Toothbrushing on Caries Incidence in Children and Adolescents Are Questioned","volume":"19","author":"Santamaria","year":"2018","journal-title":"Evid. Based Dent."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1590\/S0034-89102012005000004","article-title":"Predictors of Dental Visits for Routine Check-Ups and for the Resolution of Problems Among Preschool Children","volume":"46","author":"Camargo","year":"2012","journal-title":"Rev. Saude Publica"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41405-024-00195-7","article-title":"Impact of Dental Visiting Patterns on Oral Health: A Systematic Review of Longitudinal Studies","volume":"10","author":"Bogale","year":"2024","journal-title":"BDJ Open"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Reyes Ortiz, A., Riolobos Gonz\u00e1lez, M.F., Garc\u00eda Navas Fern\u00e1ndez de la Puebla, L., \u00c1lvarez Alonso, A., Cruz-Cruz, F., and Mart\u00edn-Vacas, A. (2026). Use of Digital Platforms and Social Media as a Source of Information on Children\u2019s Oral Health by Parents: A Cross-Sectional Survey Analysis in a Spanish Sample. Front. Oral Health, 7.","DOI":"10.3389\/froh.2026.1754009"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Peerbhay, F., Mash, R., and Khan, S. (2025). Effectiveness of Oral Health Promotion in Children and Adolescents through Behaviour Change Interventions: A Scoping Review. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0316702"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kaewkamnerdpong, I., Urwannachotima, N., Prasertsom, P., Charoenruk, N., and Krisdapong, S. (2023). Impact of Oral Diseases on 12- and 15-Year-Old Children\u2019s Quality of Life: Condition-Specific Oral Health Related Quality of Life Analysis. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03435-8"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pakkhesal, M., Riyahi, E., Naghavi Alhosseini, A., Amdjadi, P., and Behnampour, N. (2021). Impact of Dental Caries on Oral Health Related Quality of Life Among Preschool Children: Perceptions of Parents. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01396-4"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Alanzi, A., Behzadi, S., Alsumait, A., and Baskaradoss, J. (2026). Is Oral Health-Related Quality of Life of Preschool Children Affected by the Severity of Early Childhood Caries?. Front. Oral Health, 7.","DOI":"10.3389\/froh.2026.1730928"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e18742106412149","DOI":"10.2174\/0118742106412149250923073046","article-title":"Risk Factors for Caries in Children and Adolescents: A Systematic Review","volume":"19","author":"Issrani","year":"2025","journal-title":"Open Dent. J."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Qiu, R.M., Lo, E.C.M., Zhi, Q.H., Zhou, Y., Tao, Y., and Lin, H.C. (2014). Factors Related to Children\u2019s Caries: A Structural Equation Modeling Approach. 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