Parental Knowledge, Attitudes, and Practices and Their Association with Dental Caries in Children Aged 5–9 Years: A Cross-Sectional Study in Rural Ecuador

Childhood dental caries remains a critical public health issue in rural areas, where caregivers’ knowledge, attitudes, and practices (KAP) significantly influence oral health outcomes. This study assessed the association between parental KAP and the prevalence and severity of caries in children aged 5–9 years in Cayambe, Ecuador. Methods: A cross-sectional study was conducted with 229 schoolchildren and their caregivers, using a validated questionnaire and clinical examinations (ICDAS criteria). Caries severity was categorized as “obvious decay” (ICDAS 4–6) or “no obvious decay” (ICDAS 0–3). Results: Advanced dental caries affected 73.4% of children (ICDAS 4–6). While parental knowledge and attitudes showed no significant association, brushing teeth ≥2 times/day significantly reduced caries severity (p < 0.05). Sociodemographic factors, such as parental education, were not significant predictors. Conclusion: Oral hygiene practices—particularly frequent toothbrushing—were the key protective factor against severe caries, highlighting the need for behavior-focused interventions promoting daily habits. Future research should evaluate long-term preventive strategies.