# Indonesian parental knowledge, attitudes, and sources of information regarding pediatric space maintainers: a cross-sectional questionnaire-based study

## TL;DR

This study finds that Indonesian parents, especially in rural areas, lack knowledge about space maintainers, with urban parents being significantly more aware and informed.

## Contribution

The study identifies urban-rural disparities in parental awareness and information sources regarding pediatric space maintainers in Indonesia.

## Key findings

- Only 25% of parents were aware of space maintainers, with urban parents (37.5%) significantly more aware than rural parents (6.3%).
- Urban parents were 8.92 times more likely to be aware of space maintainers than rural parents.
- Awareness was linked to more favorable attitudes and comfort with dental visits, and dentists were the primary information source for urban parents.

## Abstract

Space maintainers are an important part of pediatric dentistry to prevent malocclusion after premature loss of primary teeth. The use of space maintainers are limited in developing countries such as Indonesia. This survey study was conducted to determine Indonesian parents’ knowledge, attitudes, and informational sources related to paediatric space maintainers and factors influencing awareness and acceptance.

A descriptive cross-sectional survey of 400 Indonesian parents was executed. Respondents completed a questionnaire distributed to them through clinics, schools, and publicly sponsored sites in social media. Descriptive statistics, chi-square tests, t-tests and multivariate logistic regression were conducted to study predictors of knowledge and attitudes.

Only 25% of parents indicated that they were aware of space maintainers. Urban parents (37.5%) were significantly more likely to be aware than rural parents (6.3%; χ2 = 48.35, p < 0.001). Urban location was an important predictor of the dependent variable of awareness, with urban parents being 8.92 times more likely to report awareness than rural parents (adjusted odds ratio (AOR) = 8.92, p < 0.001). At one point, awareness was related to higher comfort (p = 0.0013) and more favorable attitudes (χ2 = 10.88, p = 0.0043). Dentists were reported as the most common source of information about dental visits for parents living in urban settings (68.75%) while rural parents sourced information from community members and social media. Although awareness and attitude were correlated, for favorable perception about dental visits location was a more robust and independent predictor, (AOR for urban location = 8.27, p < 0.001).

There is a marked gap in knowledge about space maintainers, among Indonesian parents, specifically in rural areas. Targeted educational efforts and proactive dental counselling are urgently needed to improve parental awareness and promote preventive orthodontic care.