Abstract
BACKGROUND: To investigate parents’ knowledge, attitudes and practices (KAP) regarding the impact of children’s oral habits on the development of the orofacial system. METHODS: The survey, held in Taiyuan, Shanxi from Sep-Dec 2023, gathered demographic details and KAP scores through questionnaires. RESULTS: Out of 500 questionnaires analyzed, 173 respondents (34.6%) were 40 years of age or older. The median knowledge, attitude, and practice scores were 13.00 [9.00, 15.00], 32.00 [29.00, 33.00], and 45.00 [34.00, 50.00], respectively. Multivariate logistic regression indicated that higher knowledge scores (OR = 1.07, 95% CI: [1.00,1.15], P = 0.042), higher attitude scores (OR = 1.28, 95% CI: [1.18,1.40], P < 0.001), having a Master’s degree or higher (OR = 3.98, 95% CI: [1.49,10.62], P = 0.006), a monthly family income of at least 5000 Yuan (OR < 1, P < 0.005), and being employed in professions other than full-time parenting or medical roles (OR < 1, P < 0.005) were all independently associated with better practices. Structural equation modeling (SEM) demonstrated that knowledge directly influenced attitudes (β = 0.304, P < 0.001), attitudes directly influenced practices (β = 0.349, P < 0.001), and knowledge indirectly affected practices through attitudes (β = 0.106, P < 0.001). CONCLUSIONS: Parents demonstrated adequate knowledge, positive attitudes, and proactive practices regarding the impact of children’s oral habits on the development of the orofacial system. Enhancing parental education programs could further amplify knowledge and promote even more proactive practices in safeguarding children’s orofacial health. CLINICAL TRIAL NUMBER: Not applicable SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25705-6.