{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:17:56Z","timestamp":1789705076577,"version":"4.0.1"},"reference-count":41,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Childhood dental caries remains a critical public health issue in rural areas, where caregivers\u2019 knowledge, attitudes, and practices (KAP) significantly influence oral health outcomes. This study assessed the association between parental KAP and the prevalence and severity of caries in children aged 5\u20139 years in Cayambe, Ecuador. Methods: A cross-sectional study was conducted with 229 schoolchildren and their caregivers, using a validated questionnaire and clinical examinations (ICDAS criteria). Caries severity was categorized as \u201cobvious decay\u201d (ICDAS 4\u20136) or \u201cno obvious decay\u201d (ICDAS 0\u20133). Results: Advanced dental caries affected 73.4% of children (ICDAS 4\u20136). While parental knowledge and attitudes showed no significant association, brushing teeth \u22652 times\/day significantly reduced caries severity (p &lt; 0.05). Sociodemographic factors, such as parental education, were not significant predictors. Conclusion: Oral hygiene practices\u2014particularly frequent toothbrushing\u2014were the key protective factor against severe caries, highlighting the need for behavior-focused interventions promoting daily habits. Future research should evaluate long-term preventive strategies.<\/jats:p>","DOI":"10.3390\/ijerph22060953","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T11:53:14Z","timestamp":1750161194000},"page":"953","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Parental Knowledge, Attitudes, and Practices and Their Association with Dental Caries in Children Aged 5\u20139 Years: A Cross-Sectional Study in Rural Ecuador"],"prefix":"10.3390","volume":"22","author":[{"given":"Mar\u00eda","family":"Saquicela-Pulla","sequence":"first","affiliation":[{"name":"School of Dentistry, Hemisferios University, Quito 170527, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5098-6133","authenticated-orcid":false,"given":"M\u00f3nica","family":"D\u00e1vila-Arcentales","sequence":"additional","affiliation":[{"name":"Comprehensive Oral Health Research Group (GIISO), Universidad Polit\u00e9cnica Salesiana, Cuenca 170527, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7002-9990","authenticated-orcid":false,"given":"Eleonor","family":"V\u00e9lez-Le\u00f3n","sequence":"additional","affiliation":[{"name":"School of Dentistry, Catholic University of Cuenca, Cuenca 010107, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-8166","authenticated-orcid":false,"given":"Ana","family":"Armas-Vega","sequence":"additional","affiliation":[{"name":"School of Dentistry, Hemisferios University, Quito 170527, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-3308","authenticated-orcid":false,"given":"Mar\u00eda","family":"Melo","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Pozos-Guill\u00e9n, A., Molina, G., Soviero, V., Arthur, R.A., Chavarria-Bola\u00f1os, D., and Acevedo, A.M. 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