Factors associated with oral health knowledge, attitudes, and practices among legal guardians of preschool children in the Peruvian capital

Background: Legal guardians frequently serve as role models for their children. The habits they instill in their children may prove effective strategies for establishing healthy oral hygiene behaviors. The present study examined the factors associated with the level of oral health knowledge, attitudes, and practices among legal guardians of preschool children in the Peruvian capital. Furthermore, the correlation between knowledge, attitudes, and practices in oral health was assessed. Methods: This cross-sectional, analytical study evaluated 560 legal guardians of preschool children from 30 private educational institutions between July and December 2022. A validated 20-question questionnaire was employed to assess legal guardians’ knowledge, attitudes, and practices regarding oral health. Pearson’s chi-squared test and Fisher’s exact test were utilized for bivariate analysis. For multivariate analysis, a Poisson regression model with robust variance was applied using the adjusted prevalence ratio (APR). Statistical significance was set at p < 0.05. Results: A total of 82.3%, 76.2%, and 78.4% of legal guardians showed insufficient knowledge, unfavorable attitudes, and incorrect practices in oral health, respectively. The results indicated that legal guardians with high school and non-university higher education were 5.62 and 4.17 times, respectively, more likely to have insufficient oral health knowledge than those with university higher education. The same legal guardians were 6.18 and 5.02 times more likely to have an unfavorable attitude towards oral health than those with a university education (APR = 6.18, 95% CI 2.88–13.26 and APR = 5.02, 95% CI 2.32–10.90, respectively). Furthermore, these legal guardians were 4.35 and 3.08 times more likely to have incorrect oral health practices compared to those with university education (APR = 4.35; 95% CI: 2.39–7.90, and APR = 3.08; 95% CI: 1.66–5.69, respectively). On the other hand, legal guardians with a monthly family income of less than 270 USD were 14% and 15% less likely to have unfavorable attitudes and incorrect practices, respectively, compared to those with an income of 270 USD or more (APR = 0.86; 95% CI: 0.78–0.95, and APR = 0.85; 95% CI: 0.77–0.93, respectively). Finally, there was a moderate direct correlation between knowledge and attitudes (Rho = 0.56, 95% CI 0.51–0.62), knowledge and practices (Rho = 0.59, 95% CI 0.53–0.65), and attitudes and practices (Rho = 0.43, 95% CI 0.36–0.50). Conclusion: The majority of legal guardians had insufficient knowledge, unfavorable attitudes, and incorrect practices in oral health. High school and non-university higher education were risk factors for poor knowledge, unfavorable attitudes, and incorrect practices. Having a monthly family income of less than 270 USD was a protective factor for unfavorable attitudes and incorrect practices. Finally, a moderate direct correlation was identified between legal guardians’ oral health knowledge, attitudes, and practices.