# Parents’ Knowledge and Practices Regarding Children’s Oral Hygiene: A Cross-Sectional Survey

## TL;DR

This study explores how well parents in Bosnia and Herzegovina understand and practice proper oral hygiene for their children, finding gaps in early dental care and toothpaste use.

## Contribution

The study provides new insights into parental oral-hygiene practices and their association with children’s oral health in Bosnia and Herzegovina.

## Key findings

- Most parents and children brush teeth twice daily, but few start brushing before the child's first year.
- Parental knowledge and maternal education strongly predict children's oral-hygiene behaviors.
- Only 78.2% of children use age-appropriate toothpaste, with inconsistent adherence among parents of younger children.

## Abstract

Objective

To assess parents’ knowledge of recommended oral-hygiene practices for children and to describe oral-hygiene behaviors within families (parents and children), as well as factors associated with children’s oral-hygiene outcomes.

Methods

A cross-sectional study was conducted in Mostar (January-June 2025) among 405 parents or guardians of children aged 0-18 years. A structured questionnaire assessed sociodemographic characteristics, oral-hygiene habits, and parental knowledge. The questionnaire was specifically developed for this study and validated through expert review and pilot testing. Descriptive statistics, Spearman’s correlation, Mann-Whitney U, and chi-square tests were used, with statistical significance set at p<0.05.

Results

Most parents (n=367; 90.6%) and children (n=359; 88.6%) brushed their teeth at least twice daily. Only (n=139; 34.3%) of parents began brushing their child’s teeth before the first year of life, and the mean age of the first dental visit was 3.42 years. Although (n=316; 78.2%) of children used age-appropriate toothpaste, adherence to recommended toothpaste use among parents of younger children varied. Children’s oral-hygiene behaviors showed significant associations with maternal education, parents’ frequency of tooth brushing, parental use of oral-hygiene products, and parents’ self-assessed oral-health knowledge (all p<0.05). Parental knowledge and maternal education were the strongest and most consistent predictors.

Conclusion

Despite the high percentage of tooth brushing among children and parents, parents in Bosnia and Herzegovina often fail to follow recommendations for maintaining oral hygiene, such as initiating tooth brushing early, using the proper dosage of toothpaste, and scheduling an early first visit to the dentist. The results highlight the importance of national guidelines and systematic education for parents to enhance children's oral health.