{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:01:50Z","timestamp":1792789310227,"version":"4.5.0"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Public Institute for Health Sciences and the Excellence Center of Nursing Institute, Walailak University","id":[{"id":"https:\/\/ror.org\/04b69g067","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/04b69g067","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Early childhood caries (ECC) remains a major public health concern and is influenced by interactions among children, environmental, and dental care factors. Purpose: This study aimed to determine the prevalence of dental caries and identify factors associated with dental caries among preschool children in Nakhon Si Thammarat Province. Methods: A cross-sectional study was conducted among 435 children aged 3\u20135 years and their primary caregivers. Oral health was assessed by preliminary visual screening, and caregivers completed structured questionnaires on demographic characteristics, oral health attitudes and practices, and dental service utilization. Generalized estimating equations (GEEs) were used to account for clustering within child development centers. Results: Dental caries was identified in 52.6% of children, and 55.6% had visible oral uncleanliness. In multivariable GEE analysis, higher caregiver oral health care practice scores were associated with lower odds of dental caries (AOR = 0.05; 95% CI: 0.02\u20130.14; p &lt; 0.001). Children whose caregivers had an educational level below a bachelor\u2019s degree had higher odds of dental caries (AOR = 3.03; 95% CI: 2.09\u20134.41; p &lt; 0.001). Children who were never or only sometimes taken to a dentist for toothache also had higher odds of dental caries (AOR = 1.95; 95% CI: 1.31\u20132.90; p = 0.001). Conclusions: Dental caries remains common among preschool children in southern Thailand. Strengthening caregivers\u2019 practical oral health care skills and promoting preventive rather than symptom-driven dental care may support caries prevention.<\/jats:p>","DOI":"10.3390\/children13091282","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:50:03Z","timestamp":1789995003000},"page":"1282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Situation and Factors Associated with Dental Caries Among Preschool Children in Nakhon Si Thammarat Province, Thailand"],"prefix":"10.3390","volume":"13","author":[{"given":"Pastraporn","family":"Kaewpawong","sequence":"first","affiliation":[{"name":"Excellence Center of Community Health Promotion, School of Nursing, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiatkamjorn","family":"Kusol","sequence":"additional","affiliation":[{"name":"Excellence Center of Community Health Promotion, School of Nursing, Walailak University, Nakhon Si Thammarat 80160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasanah","family":"Pairoh","sequence":"additional","affiliation":[{"name":"Department of Professional Nursing Studies, Kulliyyah of Nursing, IIUM,  Kuantan Campus, Kuantan 25200, Pahang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022). Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240061484."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Maklennan, A., Borg-Bartolo, R., Wierichs, R.J., Esteves-Oliveira, M., and Campus, G. (2024). A systematic review and meta-analysis on early-childhood-caries global data. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04605-y"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e097334","DOI":"10.1136\/bmjopen-2024-097334","article-title":"Cross-sectional survey on dental caries among preschool children in Guangzhou city in 2022","volume":"15","author":"Xu","year":"2025","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Liu, M., Song, Q., Xu, X., and Lai, G. (2022). Early childhood caries prevalence and associated factors among preschoolers aged 3\u20135 years in Xiangyun, China: A cross-sectional study. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.959125"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"182","DOI":"10.4103\/jisppd.jisppd_53_25","article-title":"Prevalence of early childhood caries among preschool children of tribal Leh district of Ladakh: A cross-sectional study","volume":"43","author":"Tamchos","year":"2025","journal-title":"J. Indian Soc. Pedod. Prev. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Thakur, S., Sharma, R., Singhal, P., and Chauhan, D. (2025). Prevalence and determinants of early childhood caries among preschool children in Shimla, North India: A cross-sectional study. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-05435-2"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/idj.12261","article-title":"Early childhood caries among 5- to 6-year-old children in Southeast Asia","volume":"67","author":"Duangthip","year":"2017","journal-title":"Int. Dent. J."},{"key":"ref_8","unstructured":"Bureau of Dental Health, Department of Health (2025, March 04). Report of the 9th National Oral Health Survey 2023, Available online: https:\/\/dental.anamai.moph.go.th\/th\/."},{"key":"ref_9","first-page":"75","article-title":"Factors related to iron deficiency anemia among pre-school children in child development centers, Tasala District, Nakhon Si Thammarat Province","volume":"43","author":"Kaewpawong","year":"2018","journal-title":"J. Dep. Med. Serv."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Falconer, J.L., Rajani, R., Androshchuk, V., Yogarajah, A., Greenbury, R.A., Ismail, A., Oh, N., Nibali, L., D\u2019aGostino, E.M., and Sousa, V. (2024). Exploring links between oral health and infective endocarditis. Front. Oral Health, 5.","DOI":"10.3389\/froh.2024.1426903"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"26","DOI":"10.52442\/jrmi.v8i2.426","article-title":"Association of otitis media with dental caries in children: A systematic review","volume":"8","author":"Aziz","year":"2022","journal-title":"J. Rehman Med. Inst."},{"key":"ref_12","unstructured":"Bureau of Dental Health, Department of Health, Ministry of Public Health (2025, September 10). Guidelines for the Control and Management of Early Childhood Caries, Available online: https:\/\/dental.anamai.moph.go.th\/th\/handbook?reload=1."},{"key":"ref_13","unstructured":"World Health Organization (2010). A Conceptual Framework for Action on the Social Determinants of Health, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241500852."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Cheng, A.Y., Liu, Y., Zheng, F.M., Sun, I.G., Chen, J., and Chu, C.H. (2026). Age-related trends of caries experience among preschool children in Shenzhen, China: A cross-sectional study. Dent. J., 14.","DOI":"10.3390\/dj14030149"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Boonyawong, M., Auychai, P., and Duangthip, D. (2022). Risk factors of dental caries in preschool children in Thailand: A cross-sectional study. Healthcare, 10.","DOI":"10.3390\/healthcare10050794"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.sdentj.2023.12.001","article-title":"Nutritional factors associated with early childhood caries: A systematic review and meta-analysis","volume":"36","author":"Sandy","year":"2024","journal-title":"Saudi Dent. J."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Guan, M., Nada, O.A., Wu, J., Sun, J.-L., Li, N., Chen, L.-M., and Dai, T.-M. (2021). Dental caries and associated factors in 3\u20135-year-old children in Guizhou Province, China: An epidemiological survey (2015\u20132016). Front. Public Health, 9.","DOI":"10.3389\/fpubh.2021.747371"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zaborskis, A., Kavaliauskien\u0117, A., Razmien\u0117, J., Razmait\u0117, A., Andru\u0161kevi\u010dien\u0117, V., Narbutait\u0117, J., and Bendoraitien\u0117, E.A. (2025). Pathways between parental attitudes and early childhood caries in preschool children. Dent. J., 13.","DOI":"10.3390\/dj13050205"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Folayan, M.O., De Barros Coelho, E., Ayouni, I., Nguweneza, A., Al-Batayneh, O.B., Daryanavard, H., Duangthip, D., Sun, I.G., Arheiam, A., and Virtanen, J.I. (2024). Association between early childhood caries and parental education and the link to the Sustainable Development Goal: A scoping review. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04291-w"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Alkhtib, A., Alhatu, A., Parcelona, T., Al-Mulla, W., and Osman, S.A.A. (2025). Oral health promotion: A qualitative study to explore perspectives of kindergarten nurses in Qatar. BMC Oral Health, 25.","DOI":"10.1186\/s12903-024-05154-0"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"32","DOI":"10.15644\/asc57\/1\/4","article-title":"Dental caries experience in children in public kindergartens of Sarajevo, Bosnia and Herzegovina","volume":"57","author":"Bajric","year":"2023","journal-title":"Acta Stomatol. Croat."},{"key":"ref_22","first-page":"149","article-title":"New dental caries prevention model using the AIC participation process in lower elementary schools of Yala Province","volume":"9","author":"Suwan","year":"2022","journal-title":"South. Coll. Netw. J. Nurs. Public Health"},{"key":"ref_23","unstructured":"Nakhon Si Thammarat Provincial Public Health Office (2024, December 17). Report on Population by Gender and Annual Age Group, Nakhon Si Thammarat Province. Available online: https:\/\/hdc.moph.go.th\/center\/public\/standard-report-detail\/f83d0cd8b830706dab4cd3cb09afa584?subcatalogId=ac4eed1bddb23d6130746d62d2538fd0."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1177\/001316447003000308","article-title":"Determining sample size for research activities","volume":"30","author":"Krejcie","year":"1970","journal-title":"Educ. Psychol. Meas."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Min, S.N., Duangthip, D., Gao, S.S., and Detsomboonrat, P. (2024). Early childhood caries and its associated factors among 5-year-old Myanmar children. Front. Oral Health, 5.","DOI":"10.3389\/froh.2024.1278972"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gunasinghe, K.A.M.M., Wijesinghe, M.S.D., and Ratnayake, N.C. (2024). Socio-behavioral associates of early childhood caries among preschool children aged three to four years in Gampha District, Sri Lanka: A cross-sectional study. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-05060-5"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Al-Sharani, H.M., Stormon, N., Al-Hutbany, N., Zhang, Y., and Zulfiqar, T. (2025). Optimal tooth brushing initiation age and frequency for preventing early childhood caries: A systematic review and meta-analysis. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-07179-5"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Cheng, A.Y., Chen, J., Zheng, F.M., Duangthip, D., and Chu, C.H. (2025). Early childhood caries and its associated factors among 5-year-old children in Shenzhen City, China: A cross-sectional study. Dent. J., 13.","DOI":"10.3390\/dj13120552"},{"key":"ref_29","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_30","first-page":"245","article-title":"Oral health knowledge, attitudes and behavior of parents and caregivers of preschool children: Implications for oral health promotion","volume":"18","author":"Naidu","year":"2020","journal-title":"Oral Health Prev. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Badrov, M., Matijevic, M., and Tadin, A. (2025). Parental knowledge of breastfeeding and nutrition: Influence on oral health and self-reported early childhood caries in preschool children in Croatia. Pediatr. Rep., 17.","DOI":"10.3390\/pediatric17020043"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"111","DOI":"10.11606\/s1518-8787.2021055003929","article-title":"Contributions of school context to caries on anterior teeth: A multilevel analysis","volume":"55","author":"Prata","year":"2021","journal-title":"Rev. Saude Publica"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1282\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:40:40Z","timestamp":1789998040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["children13091282"],"URL":"https:\/\/doi.org\/10.3390\/children13091282","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}