Abstract
BACKGROUND/OBJECTIVES: Early childhood oral health is strongly influenced by parental and caregiver behaviors, yet evidence on the impact of sociodemographic factors remains limited in Eastern European settings. This study evaluated the association between parental and caregiver sociodemographic characteristics (age, educational level, and living environment) and oral health-related behaviors, dental attendance, and caries experience among preschool children in Romania. METHODS: A cross-sectional study was conducted among parents or caregivers of children aged 0-6 years (n = 490). Data were collected between September and November 2025 using a structured online questionnaire (24 items). Statistical analyses included Fisher's exact test, Mann-Whitney U test, Kruskal-Wallis test with post hoc analysis, and Spearman's correlation (p < 0.05). RESULTS: Higher parental education was consistently associated with favorable oral health behaviors, including earlier initiation of oral hygiene, parent-assisted toothbrushing, use of fluoridated toothpaste, and preventive dental visits (p < 0.01). Children of parents aged 21-30 years were more frequently caries-free (62.7%), whereas caries prevalence was higher among those with parents aged 41-50 years (60.5%) (p < 0.05). Urban residence was associated with twice-daily toothbrushing (49.4% vs. 36.2%) and earlier dental visits compared with rural residence (p < 0.05). CONCLUSIONS: Parental education, age, and living environment are significantly associated with early oral health behaviors and caries experience. Preventive programs should prioritize families with lower educational levels and those living in rural areas.