Do oral health literacy, economic status, and education of parents or caregivers influence the choice of pediatric dental procedures? A cross-sectional study

Carlos Eduardo Lopes Albuquerque¹ image, Ana Cristina Beviláqua Batista Pedrosa2 image, Fernanda Urbini Romagnolo3 image, Marinilza Soares Mota Sales4 image, Sarah Mendes de Sousa Macedo Silva5 image, Renata Freitas Lemos de Oliveira6 image, Evyllen Ponte Aguiar7 image, Victor Cavallaro Bottesini8 image, Danilo Antonio Duarte9 image

Highlights

Caregiver oral health literacy, education, and socioeconomic status strongly influence pediatric dental treatment decisions.

Low oral health literacy and socioeconomic vulnerability increase preference for invasive procedures instead of conservative approaches.

Findings highlight the need for targeted health education to improve parental decision-making and promote minimally invasive care.

Abstract

Aim: The knowledge and behavior of parents or caregivers are strongly linked to the oral health outcomes of their children. Identifying factors that influence treatment choices is essential for improving pediatric dental care. This study aimed to assess the impact of oral health literacy (OHL), education level, and socioeconomic status of parents or caregivers on the selection of pediatric dental procedures for their children. Methods: An analytical cross-sectional study was conducted with 423 parents or caregivers responsible for children aged 3–12 years attending a university dental clinic. Three instruments were used: (1) a questionnaire assessing sociodemographic characteristics and family oral health, (2) the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and (3) a validated tool presenting clinical images of carious lesions with multiple treatment options. Data were analyzed using descriptive statistics and Spearman’s rank correlation test, with significance set at 5% (p < 0.05). Results: Of the participants, 76.2% were female, with a mean age of 36 years. Most respondents (76.5%) belonged to economic class C or lower. The mean BREALD-30 score was 19.36 (SD = 6.94), with 53% classified as having normal OHL. Caregivers with lower OHL, lower educational attainment, and greater socioeconomic vulnerability demonstrated a strong preference for invasive treatments, such as tooth extraction, particularly in advanced caries scenarios. Spearman’s correlation analysis revealed significant associations between OHL scores, education, socioeconomic class, and treatment preferences (p < 0.01). Conclusions: The combination of low OHL, limited education, and economic disadvantage influences parental decision-making, favoring invasive procedures over conservative approaches. These findings underscore the need for targeted oral health education and preventive strategies aimed at caregivers to promote minimally invasive treatment choices for children.

Keywords: Health Literacy; Health Promotion; Oral Health; Pediatric Dentistry; Socioeconomic Factors

Author Affiliations

  1. PhD, Department of Oral and Maxillofacial Surgery, UNINTA, Brazil (Correspondence:carlosedubuco@gmail.com)
  2. PhD, Department of Oral and Maxillofacial Surgery, UNINTA, Brazil
  3. PhD, Department of Pediatric Dentistry, São Leopoldo Mandic College, Brazil
  4. Master, Department of Public Health, State University of Montes Claros (UNIMONTES), Brazil
  5. Master, Department of Pediatric Dentistry, UNINTA, Brazil
  6. Master, Department of Medical Pediatrics, Ceará Federal University (UFC), Brazil
  7. Graduated, Department of Pediatric Dentistry, UNINTA, Brazil
  8. PhD Student, Department of Restorative Dentistry, São Paulo State University (UNESP), Brazil
  9. PhD, Department of Pediatric Dentistry, São Leopoldo Mandic College, Brazil
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Article Info

Contemp Pediatr Dent 2025:6(2):123-134

Received: 11 February 2025

Accepted: 17 June 2025

Online First: 25 July 2025

DOI: 10.51463/cpd.2025.07

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					Carlos Eduardo Lopes Albuquerque, Ana Cristina Beviláqua Batista Pedrosa, Fernanda Urbini Romagnolo, Marinilza Soares Mota Sales, Sarah Mendes de Sousa Macedo Silva, Renata Freitas Lemos de Oliveira, Evyllen Ponte Aguiar, Victor Cavallaro Bottesini, Danilo Antonio Duarte. Do oral health literacy, economic status, and education of parents or caregivers influence the choice of pediatric dental procedures? A cross-sectional study. Contemp Pediatr Dent 2025:6:2:123-134

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