Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand

Objectives: Early childhood caries is a significant oral health issue that progresses rapidly and affects the long-term health and quality of life of preschool children. Therefore, this study aimed to study the oral health behaviors and their predictors among parents of preschool children in Samut Sakhon, Thailand.

Methods: A cross-sectional design was employed with a sample of 351 parents of preschool children, selected through multi-stage random sampling. Data were collected using a questionnaire developed based on theoretical frameworks and study objectives,comprising four parts: personal factors, oral health knowledge, Health Belief Model-based oral health beliefs, and parental oral health behaviors. The instruments demonstrated a content validity (IOC) of 0.66–1.00 and a Cronbach's alpha coefficient of 0.896. Descriptive statistics, correlation analysis, and stepwise multiple regression were used for data analysis.

Results: The results indicated that 53.6% of parents exhibited moderate oral health behaviors for their children (Mean=55.95, SD=10.575). Factors significantly predicting oral health behaviors, accounting for 32.4% of the variance (R²=0.324, p<0.05), included cues to action (β=0.323), perceived barriers (β=0.296), oral health knowledge (β=0.125), educational background (β=0.117), and perceived severity of oral health issues (β=0.103).

Conclusions: Findings suggest the need for targeted interventions to improve oral health behaviors among parents, focusing on oral hygiene, milk bottle care, nutrition, and dental visits. Programs should raise awareness and provide educational resources on preschool oral health to promote better oral hygiene practices.

References

  1. Department of Dental Public Health. Oral health promotion: The gateway to good health at all stages of life. Bangkok: Veterans Affairs Printing Organization; 2012.
  2. World Health Organization. Oral health [Internet]. Geneva: World Health Organization; 2025 [cited 2025 Mar 20]. Available from: https://who.int/news-room/fact-sheets/detail/oral-health
  3. World Health Organization [Internet]. Geneva: The Association. Seventy-fourth World Health Assembly Agenda item 13.2 Oral health; 2021 [cited 2023 Oct 2]. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA74-REC1/A74_REC1-en.pdf
  4. Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015;94(5):650-8.
  5. Department of Dental Public Health. The $8^{th}$ National Oral Health Status Survey Report, Thailand 2017. Bangkok: Samjaeroen Panit (Bangkok) Co., Ltd.; 2018.
  6. Sitthisettapong T, Tasanarong P, Phantumvanit P. Strategic management of early childhood caries in thailand: a critical overview. Front Public Health. 2021;9:664541.
  7. Drury TF, Horowitz AM, Ismail AI, Maertens MP, Rozier RG, Selwitz RH. Diagnosing and reporting early childhood caries for research purposes. J Public Health Dent. 1999;59(3):192-7.
  8. Trairattvorakul C. Preventive dentistry in children and adolescents [Internet] 3rd ed. Bangkok: Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University; 2010 [cited 2023 Sep 30]. Available from: https://www.slideshare.net/dentyomaraj/article-20100319085628
  9. Health Promotion Bureau. Strategic plan for early childhood oral health promotion 2018-2022. Department of Health, Ministry of Public Health; 2018.
  10. Boontham K, Leelarasamee S. The relationship between dental caries and nutritional status in Thai children aged 5 years. Th Dent Public Health J. 2016;21(2):47-53.
  11. Department of Dental Public Health. The 9th National Oral Health Status Survey Report, Thailand 2023. $1^{st}$ ed. Bangkok: Samjaeroen Panit (Bangkok) Co., Ltd.; 2024.
  12. American Academy of Pedodontics, American Academy of Pediatrics. Nursing bottle caries. January, 1978. Reference Manual 1991-1992. Chicago, III.: American Academy of Pediatric Dentistry; 1991:27.
  13. Becker MH. The health belief model and personal health behavior. Health Educ Monogr. 1974;2(4):324-473.
  14. Samutsakhon Provincial Industry Office [Internet]. [cited 2025 Mar 9]. Available from: https://samutsakhon.industry.go.th/th/cms-of-20364/
  15. Baek SU, Won JU, Yoon JH. The role of work-family conflict in the association between long working hours and workers' sleep disturbance and burnout: results from the sixth Korean Working Conditions Survey. BJPsych Open. 2023;9(5):e165.
  16. Ministry of Education [Internet]. Bangkok: Information and Communication Technology Center. Educational Statistics 2023, Samut Sakhon Provincial Education Office, Ministry of Education; 2023 [cited 2023 Oct 2]. Available from: https://edustatistics.moe.go.th/school74
  17. Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 6th ed. New York: Wiley & Sons; 1995.
  18. Bujang MA. A step-by-step process on sample size determination for medical research. Malays J Med Sci. 2021;28(2):15-27.
  19. Kladkaew S. Primary teeth are not important? Leave them, and permanent teeth will replace them soon. Hfocus. 2022 Sep 20. Available from: https://www.hfocus.org/content/2022/09/26035
  20. Industrial Estate Authority of Thailand. Industrial estates [Internet]. Industrial Estate Authority of Thailand; [cited 2025 Mar 9]. Available from: https://www.ieat.go.th/th/estates
  21. Industrial Estate Authority of Thailand. Dissolution of Industrial Estates [Internet]. Industrial Estate Authority of Thailand; [cited 2025 Mar 9]. Available from: https://data.t.go.th/dataset/dissolution1/resource/707250ce-cde4-4222-8ed6-49701acf73c6
  22. Samutsakhon Provincial Industry Office. Number of industrial factories granted operation licenses by industry type [Internet]. Samutsakhon Provincial Industry Office; [cited 2025 Mar 9]. Available from: https://samutsakhon.industry.go.th/th/cms-of-287
  23. National Statistical Office of Samutsakhon. Pocketbook 2 [Internet]. National Statistical Office of Samutsakhon; [cited 2025 Mar 9]. Available from: https://smsakhon.nso.go.th/reports-publications/ebook.html?view=book&id=32:pocketbook2&catid=6:smsakhonstat_book
  24. Lee Y, Lee S, Kim YJ, Kim Y, Kim SY, Kang D. Relationship between of working hours, weekend work, and shift work and work-family conflicts among Korean manufacturers. Ann Occup Environ Med. 2022;34:e20.
  25. Choi BY, Min JY, Ryoo SW, Min KB. Use of work-related communication technology outside regular working hours and work-family conflict (work interference with family and family interference with work): results from the 6th Korean working conditions survey. Ann Occup Environ Med. 2022;34:e44.
  26. Ervasti J, Pentti J, Nyberg ST, Shipley MJ, Leineweber C, Sorensen JK, et al. Long working hours and risk of 50 health conditions and mortality outcomes: a multicohort study in four European countries. Lancet Reg Health Eur. 2021;11:100212.
  27. Rathajak V, Numkham L, Pongpan S. Factors predicting oral health care behavior among children under the age of 1 years and a half to 3 years of parents in Wiangsa District, Nan Province. TSTJ. 2020;28(8):1473-89.
  28. Kongmai N, Chaiyasang U, Kajkamhang S, Chaiyasang N. Factors related to oral health care behaviors in preschool children among parents in Chamuang Sub-district, Khuan Khanun District, Phatthalung Province. TJPHS. 2019;2(2):26-42.
  29. Bhan G, Surie A, Horwood C, Dobson R, Alfers L, Portela A, et al. Informal work and maternal and child health: a blind spot in public health and research. Bull World Health Organ. 2020;98(3):219-21.
  30. Surkan PJ, Kiihl SF, Kozuki N, Vieira LMC. Social support of low-income Brazilian mothers related to time to completion of childhood vaccinations. Hum Vaccin Immunother. 2012;8(5):596-603.
  31. Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369(9556):145-57.
  32. Smith Fawzi MC, Andrews KG, Fink G, Danaei G, McCoy DC, Sudfeld CR, et al. Lifetime economic impact of the burden of childhood stunting attributable to maternal psychosocial risk factors in 137 low/middle-income countries. BMJ Glob Health. 2019;4(1):e001144.
  33. Janjaratjinda K, Satitvipawee P, Jareinpitak S, Tipayamongkholgul M. Factors associated with early childhood caries among children living in sugar palm plantation communities, Phetchaburi Province, Thailand. Southeast Asian J Trop Med Public Health. 2023;54(6):376-91.
  34. Juajan K, Sinchai I, Nammontri O, Silalai A, Sukcharoenkosol H. Parents oral health care behaviors and caries status of preschool children in Kaengkhoi District, Saraburi Province. JBCNM. 2016;22(1):5-17.
  35. Kabiri B, Hidarnia AR, Alavijeh MM, Motlagh ME. Mothers' role in promoting oral health in children aged 6 months to 1 year. J Family Med Prim Care. 2021;10(9):3273-6.
  36. Kaushik M, Sood S. A systematic review of parents' knowledge of children's oral health. Cureus. 2023;15(7):e41485.
  37. Shan Z, Liao C, Lu J, Yeung CPW, Li KY, Gu M, et al. Improvement of parents' oral health knowledge by a school-based oral health promotion for parents of preschool children: a prospective observational study. BMC Oral Health. 2023;23:890.
  38. Chen L, Hong J, Xiong D, Zhang L, Li Y, Huang S, et al. Are parents' education levels associated with either their oral health knowledge or their children's oral health behaviors?. BMC Oral Health. 2020;20:203.
  39. Gudipaneni RK, Alzabni KMD, Alrashedi FFA, Alruwaili DHJ, Albalawi FA, Alanazi AH, et al. The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study. BMC Oral Health. 2024;24(1):853.
  40. Balasubramanian S, Shrikrishna SB, Shenoy R, Rao A. Association of maternal and child dental anxiety with dental caries experience and dental attendance pattern of the child. J Orofac Sci. 2018;10(2):75-9.

Chaiyasak K, Sarnkhaowkhom C, Therawiwat M, Pekalee A. Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand: Original articles. Oral Sci Rep [Internet]. 2026 Aug 07 [cited 2026 Aug 08];47(3):352-361. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=560

Chaiyasak, K., Sarnkhaowkhom, C., Therawiwat, M. & Pekalee, A. (2026). Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand. Oral Sci Rep, 47(3), 352-361. Retrieved from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=560

Chaiyasak, K., Chawapon Sarnkhaowkhom,Manirat Therawiwat and Alongkorn Pekalee. 2026. "Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand." Oral Sci Rep, 47(3), 352-361. https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=560

Chaiyasak, K. et al. 2026. 'Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand', Oral Sci Rep, 47(3), 352-361. Retrieved from https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=560

Chaiyasak, K., Sarnkhaowkhom, C., Therawiwat, M. and Pekalee, A. "Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand", Oral Sci Rep, vol.47, no. 3, pp. 352-361, Aug. 2026.

Chaiyasak, K., Sarnkhaowkhom, C., Therawiwat, M., et al. "Oral Health Behaviors and Predictive Factors Among Parents of Preschoolers in an Industrial Urban Setting: A Case Study in Mueang District, Samut Sakhon, Thailand." Oral Sci Rep, vol.47, no. 3, Aug. 2026, pp. 352-361, https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=560