Abstract
<jats:p>Background: Early childhood caries (ECC) remains a major public health concern and is influenced by interactions among children, environmental, and dental care factors. Purpose: This study aimed to determine the prevalence of dental caries and identify factors associated with dental caries among preschool children in Nakhon Si Thammarat Province. Methods: A cross-sectional correlational study was conducted among 435 preschool children aged 3–5 years and their primary caregivers in Nakhon Si Thammarat Province, Thailand. Data were collected using oral health examinations and structured questionnaires completed by caregivers. The questionnaires assessed demographic characteristics, caregivers' oral health attitudes and practices, and access to and utilization of dental services. Data was analyzed using descriptive statistics, chi-square tests, and binary logistic regression. Results: The prevalence of dental caries was 52.6%, and 55.6% of children had poor oral hygiene. The factors associated with dental caries included bottle-feeding, frequency and duration of toothbrushing, having a toothbrushing assistant at home, caregiver education level, attitude, caregivers’ oral health care behaviors for children, and visiting the dentist for toothaches, check-ups, and fluoride application (p &lt; 0.01). Binary logistic regression confirmed that caregivers' oral health care practices were most strongly associated with dental caries. Children whose caregivers had low-to-moderate oral health care practices were 7.11 times more likely to have dental caries than those whose caregivers had high oral health care practices (AOR = 7.11; 95% CI: 4.11-12.32; p&lt;0.001). And factors associated with dental caries included caregiver education below a bachelor's degree (AOR = 2.64; 95% CI: 1.64-4.23; p &lt; 0.001), toothbrushing once daily (AOR = 2.20; 95% CI: 1.07-4.52; p &lt; 0.05), and never/sometimes visiting a dentist only when experiencing toothache (AOR = 2.26; 95% CI: 1.36-3.74; p &lt; 0.01). Conclusions: Dental caries remains highly prevalent among preschool children in southern Thailand. Caregiver oral health care was a strong predictor of dental caries. Oral health promotion programs should strengthen caregivers' practical skills in oral health care and encourage regular preventive dental care by collaborating among families and primary healthcare providers.</jats:p>