Identifying dietary patterns and their association with oral health behaviors in young children: a parent-based cross-sectional study in Lithuania.

Background: Children's oral health and nutrition are interconnected, jointly influencing growth, oral development, and disease prevention such as caries. Despite this connection, they are often addressed separately in research and practice, underscoring the need for validated parental assessment tools that support integrated and interdisciplinary prevention strategies. Methods: This cross-sectional study examined underlying dietary patterns among 420 children aged 5-12 years in Kaunas, Lithuania, based on parental reports. Data were collected as part of a broader investigation of oral health behavior (OHB) and knowledge. Children's consumption habits were assessed using 17 structured dietary items, which were further used to adapt nutritional assessment subscales. Ethical approval was obtained from Kaunas Kolegija HEI. Exploratory factor analysis (EFA) was conducted to identify underlying dietary dimensions, and associations with sociodemographic variables and OHB were examined using correlation and regression analyses. Results: EFA revealed a three-factor model explaining 40.30% of total variance, comprising: "recommended healthy foods" (e.g., fruits, vegetables), "inappropriate drinks and snacks" (e.g., sugary beverages), and "dairy products." Dietary measures were not associated with parents' age, gender, or self-perceived nutrition knowledge. Parents' education type was positively associated with "dietary" and "recommended healthy foods", while children's age showed negative associations with these variables, indicating less healthy dietary patterns in older children. OHB was positively associated with "recommended healthy foods", "dietary", and fruit and vegetable intake, but negatively associated with inappropriate drinks and snacks. Regression analysis revealed that consumption of "recommended healthy foods" and "parental success in ensuring healthy eating" as significant independent predictors of optimal OHB. Conclusions: These findings provide empirical support a multidimensional, parent-based dietary assessment framework that captures distinct eating patterns relevant to oral health. Integrating such tools into oral health promotion may enhance early prevention strategies by linking dietary behaviors with oral hygiene practices in a structured and evidence-based manner.