The association between parental oral health literacy, socio-demographic characteristic, patient factors and caries status of paediateric cancer patient: a cross-sectional study.

Background: Paediatric cancer patients (PCPs) are reported to experience poorer dental health compared to their healthy peers. Contributing factors include low parental oral health literacy (OHL), suboptimal oral health behaviours among PCPs, and various clinical factors. However, there is limited data on the caries status of PCPs in Malaysia, and the relationship between caries status and parental OHL remains unexplored. This study aimed to evaluate PCPs' caries status, assess parental OHL, and identify other factors influencing caries status in this population. Methods: A cross-sectional study was conducted with 212 parent/PCP pairs at two local hospitals. Data collection occurred in three phases: (I) retrieving PCP details from medical records and conducting face-to-face interviews with parents to gather sociodemographic information and details about the children's oral health behaviours; (II) administering a self-reported questionnaire to parents to assess their OHL using the validated Malay version of the 14-item Health Literacy in Dentistry questionnaire (M-HeLD-14); and (III) performing oral examinations of the PCPs. Results: The PCPs ranged in age from 4 to 17 years, with a male majority (57.5%) and a primary diagnosis of leukaemia (62.7%). The prevalence of dental caries was 52.8% [95% confidence interval (CI): 46.06-59.61], with a median decayed, missing, and filled teeth (dmft) score of 3 [interquartile range (IQR), 7]. While 61.3% of parents exhibited inadequate OHL; this was not significantly associated with the PCPs' caries status [odds ratio (OR) 0.638; 95% CI: 0.328-1.241]. Factors significantly associated with a higher likelihood of dental caries included younger age (OR 2.785; 95% CI: 1.419-5.468; P=0.009), infrequent toothbrushing (OR 2.606; 95% CI: 1.398-4.855; P=0.007), frequent consumption of sugar-containing snacks or beverages between meals (OR 3.324; 95% CI: 1.758-6.287; P<0.001), and symptomatic referral to a dentist following cancer diagnosis (OR 2.556; 95% CI: 1.372-4.761; P<0.001). Conclusions: Improving parental OHL alone may not be sufficient to enhance the caries status of PCPs. A more comprehensive and multidisciplinary approach is necessary, including early referral to a Paediatric Dental team upon cancer diagnosis, systematic follow-up, and implementation of a caries prevention program with regular reinforcement.