Parental Knowledge of Dental Erosion and Erosion-Related Risk Factors in Children in various regions of Saudi Arabia.

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Saud Shaher Almutairy, Haneen Mohammed AlAyyaf, Sara waslullah Alhjajji, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9390474/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Introduction: Dental erosion, a growing concern among children in Saudi Arabia, involves the chemical degradation of tooth enamel due to nonbacterial acids. This study focuses on assessing parental knowledge regarding dental erosion and its risk factors. Methodology: A cross-sectional study was conducted using a structured Arabic-language questionnaire distributed online. Data from 396 parents of preschool children (aged 3–6 years) from different regions in Saudi Arabia were collected through convenient sampling via social media messaging platforms. Descriptive analyses were performed and counts and percentages were reported. Chi-square tests were conducted. Results Among the participants, 80% had heard of dental erosion. However, only 51.6% correctly identified acids as the cause, while 40% of respondents incorrectly linked it to dental caries. Understanding of dental erosion varied significantly by participants' education level (p < 0.05). Most participants recognized erosion as a serious condition (73.8%) and reported it affected general health (84.8%). However, only 30.2% were aware of available treatments, whereas 62.3% knew prevention methods. Conclusion Although most parents in the sample had heard of erosion, many reported limited knowledge of available treatment options. Educational level influences knowledge and dental care behaviors. Additionally, dietary habits and inconsistent dental visits remain prevalent, underscoring the need for targeted public health education. Parental knowledge dental erosion erosion-related risk acid effect parent education Introduction Dental erosion is characterized by the chemical deterioration of the hard tooth structure resulting from exposure to acids of nonbacterial origin [1]. In its initial stages, erosive tooth wear typically presents as a smooth, silky, glazed appearance on the enamel surface [2]. Changes in tooth morphology become more noticeable as the disease progresses[2]. The development of cavities or grooves on the occlusal surfaces, loss of perikymata, and the presence of intact enamel near the gingival margin are typical clinical signs[3]. Because of their subtlety, lack of obvious symptoms, and ease of overlooking during clinical examination, these early manifestations often lead to delayed diagnosis and intervention [3]. Tooth erosion may occur because of acids of intrinsic origin, such as those associated with gastroesophageal reflux disease (GERD), where stomach acid enters the oral cavity through voluntary or involuntary reflux episodes[4,5]. Furthermore, erosive tooth wear is largely caused by extrinsic factors, especially the frequent consumption of acidic foods and drinks. For example, regular consumption of fruit juices, soft drinks, and citrus fruits has been closely associated with a higher risk of erosion [4,5]. An important factor influencing erosive potential is the pH level at the tooth surface after consuming an acidic beverage. Citric, phosphoric, ascorbic, malic, and carbonic acids are common dietary acids linked to dental erosion; citric acid has a significantly higher erosive potential than the others[3–5]. The progression of erosion is influenced by several factors that can be prevented or at least controlled. These factors include lifestyle, dental prevention care, and overall health. Over the past 10 years, the number of people with tooth erosion has increased, likely due to the increased consumption of acidic beverages, such as soft drinks and fruit juices[6]. This is particularly true for children and adolescents, who tend to drink more acidic beverages than adults [6,7]. Many factors affect the severity of erosion. The type of acid, how long it remains on the tooth, and other ingredients in the beverage all play a role. For example, if a beverage contains calcium, phosphate, or fluoride, it may help protect the tooth. However, if the beverage is highly acidic and remains on the tooth for a long time, it increases the likelihood of enamel erosion. Other factors, such as the amount of saliva a person produces, their oral hygiene, and the type of food they eat, also play a role in the development and severity of tooth erosion [6–8]. Saliva is one of the most important factors contributing to preventing tooth erosion [9]. It does this by producing a protective layer, reducing acids on the tooth surface, cleaning and neutralizing them, and combating the factors that cause erosion [9,10]. Saliva is essential to prevent the demineralization of tooth enamel and to promote remineralization processes due to its richness in minerals[9,11]. Saliva also helps patients with GERD maintain balance in the digestive system and oral cavity[12]. Reduced saliva flow, commonly referred to as xerostomia, significantly weakens these protective mechanisms, increasing teeth’s vulnerability to erosive damage [12]. The importance of these risk factors has been well established in population-based studies conducted in Saudi Arabia. For instance, a study by Al-Dlagian et al. of 388 children in Riyadh found that 47% had mild erosion, 10% had moderate erosion, and 4% had severe erosion. Notably, 60% of the participants reported regularly consuming juice drinks, and of these, 84% showed signs of erosion. This indicates a strong and statistically significant association (p < 0.005) between daily juice consumption and the prevalence of erosion. Furthermore, the study highlighted another behavioral risk factor, holding liquids in the mouth before swallowing, which also showed a significant association with erosion incidence (p < 0.02) [13]. These findings provide experimental support for the role of the frequency of acidic beverage consumption and behavioral patterns in accelerating tooth enamel degradation. A similar result was seen in a study by Al-Malik et al. a clinical examination of 987 children showed that 31% had tooth loss affecting the labial and/or palatal surfaces of the upper incisors. These lesions have been attributed, in whole or in part, to erosive processes[14]. The localized pattern of tissue loss is consistent with exposure to dietary acids and is in line with the mechanisms discussed previously, such as the duration of acid contact and tooth surface sensitivity. These studies show that dental erosion could be common among Saudi children and show how important it is to change lifestyle and eating habits at the individual and community levels[13–17]. Studies have indicated that parents continue to have an influence on their children aged 8 to 9 years and are the primary influencer of this age group’s beverage choices [18,19]. The primary aim of this study was to assess parental knowledge regarding dental erosion and its associated risk factors of children aged 3–6 years in Saudi Arabia. Materials and Methods This cross-sectional study was conducted to evaluate parental knowledge regarding dental erosion and its associated risk factors among parents of preschool children aged 3–6 years in Saudi Arabia. The data collection period extended from August to December 2024. The data were collected using a structured self-administered questionnaire distributed to the parents visiting pediatric dentistry clinics in several regions across Saudi Arabia digitally through messaging platforms (particularly WhatsApp and Telegram). A convenient sampling technique was used, and participation in the study was entirely voluntary. All participants provided informed consent prior to completing the questionnaire. Responses were anonymous and treated with strict confidentiality. The study protocol was reviewed and approved by the Institutional Review Board (IRB) of Umm Al-Qura University, Makkah, Saudi Arabia, with IRB approval number HAPO-02-K-012-2025-02-2529. The target population of this study consisted of parents of preschool children in Saudi Arabia. The required sample size was calculated using a 95% confidence level and a 5% margin of error. Based on this, a minimum sample size of 385 was estimated. Inclusion criteria were being Saudi nationals and parents of at least one child in preschool aged 3–6 years. The exclusion criteria were non-Saudi parents and parents who have children that didn’t fall within the preschool age group. The questionnaire was adapted from previously validated instruments and modified to suit the Saudi cultural and linguistic context [19,20]. It was written in Arabic and underwent a pilot test with a small group of parents to ensure clarity and relevance. Minor revisions were made based on their feedback. The first section of the questionnaire consisted of demographic information, which included questions on the parents’ age, gender, marital status, nationality, region of residence, educational level, employment status, monthly income, and number of children. The second section included questions about knowledge of dental erosion and its risk factors. The third section included questions about the prevention and management of dental erosion. Descriptive statistics (frequencies and percentages) were used to summarize the data. A chi-square test was applied to examine the associations between the categorical variables. A p-value < 0.05 was considered statistically significant. All statistical analyses were conducted using STATA software, version 18.0. Results Table 1 presents the distribution of demographic data in relation to parents heard about dental erosion. Of the 396 respondents, 299 (79.9%) had heard of dental erosion, while 75 (20.1%) had not. This did not differ significantly by gender (p = 0.205), with 82.8% of males and 77.5% of females reporting prior knowledge of the term dental erosion. Across age groups, it was relatively consistent, ranging from 75.6% among those aged 46–50 years to 82.7% among those aged 20–25 years, with no significant differences observed (p = 0.835). Educational level also showed no significant association (p = 0.376), although parents with more than a high school education reported slightly higher (80.9%) compared to those with a high school education or less (76.3%). Regional distribution revealed that the participants from the south (92.9%) heard about the term erosion more than those from the east (76.4%), but these differences were not statistically significant (p = 0.440). Regarding family size, parents with only one child reported the highest level (88.3%), while those with four children showed the lowest (72.9%), although this trend was not statistically significant (p = 0.245). Similarly, no significant differences were observed across employment status (p = 0.766) or marital status (p = 0.169). In terms of income, which ranged from 74.0% among parents earning 10,000–15,000 SAR to 88.1% among those earning 15,000–20,000 SAR, with no significant differences (p = 0.453). Table 1 Demographic Variables and Knowledge of Dental Erosion Among Parents Demographic variable Heard of dental erosion P-value Total 396 Yes No n (%) n (%) n (%) Gender 299 (79.95%) 75 (20.05%) Males 181 (45.71%) 144 (82.76%) 30 (17.24%) 0.205 Females 215 (54.29%) 155 (77.50%) 45 (22.50%) Age (years) 20–25 82 (20.71%) 62 (82.67%) 13 (17.33%) 0.835 26–35 160 (40.40%) 120 (79.47%) 31 (20.53%) 36–45 113 (28.54%) 86 (80.37%) 21 (19.63%) 46–50 41 (10.35%) 31 (75.61%) 10 (24.39%) Educational level high school or less 93 (23.48%) 58 (76.32%) 18 (23.68%) 0.376 More than high school 303 (76.52%) 241 (80.87%) 57 (19.13%) Region West 112 (28.28%) 84 (84.00%) 16 (16.00%) 0.440 Central 200 (50.51%) 149 (77.60%) 43 (22.40%) East 55 (13.89%) 42 (76.36%) 13 (23.64%) North 14 (3.54%) 11 (84.62%) 2 (15.38%) South 15 (3.79%) 13 (92.86%) 1 (7.14%) How many kids in the family One kid 61 (15.40%) 53 (88.33%) 7 (11.67%) 0.245 Two kids 101 (25.51%) 74 (77.89%) 21 (22.11%) Three kids 89 (22.47%) 69 (83.13%) 14 (16.87%) Four kids 64 (16.16%) 43 (72.88%) 16 (27.12%) More than 4 kids 81 (20.45%) 60 (77.92%) 17 (22.08%) Employment status Unemployed 153 (38.64%) 115 (82.73%) 24 (17.27%) 0.766 Employed 204 (51.52%) 156 (78.00%) 44 (22.00%) Student 32 (8.08%) 24 (80.00%) 6 (20.00%) Retired 7 (1.77%) 4 (80.00%) 1 (20.00%) Marital status Married 354 (89.39%) 268 (80.48%) 65 (19.52%) 0.169 Single 32 (8.08%) 25 (80.65%) 6 (19.35%) Divorced 8 (2.02%) 4 (50.00%) 4 (50.00%) Widowed 2 (0.51%) 2 (100%) 0 Income in Saudi Riyal less than 5 thousand 143 (36.11%) 98 (79.67%) 25 (20.33%) 0.453 5–10 thousand 105 (26.52%) 85 (81.73%) 19 (18.27%) 10–15 thousand 77 (19.44%) 57 (74.03%) 20 (25.97%) 15–20 thousand 42 (10.61%) 37 (88.10%) 5 (11.90%) More than 20 thousand 29 (7.32%) 22 (78.57%) 6 (21.43%) Table 2 illustrates parental knowledge regarding dental erosion in relation to educational level. More than half of the parents correctly identified dental erosion as being caused by acids (51.6%), with a higher proportion among those with more than high school education (87.6%) compared to the lower education group (12.4%). Around 40.6% of parents thought dental erosion was due to dental caries, while smaller proportions attributed it to tooth cracks (2.9%) or discoloration (4.8%). A p-value of (0.002) indicates that the understanding of what dental erosion is varied significantly based on the education level of the participants. Regarding the seriousness of the condition, 73.8% of the parents recognized dental erosion as a serious health issue, with no significant difference in educational levels (p = 0.423). Similarly, 84.8% of parents reported that dental erosion could affect a child’s overall health, although the difference between the groups was not statistically significant (p = 0.054). When asked about dietary habits, a statistically significant association was observed between educational level and the frequency of allowing children to consume acidic drinks (p = 0.005). On the other hand, no significant association was found between educational level and the frequency of sugary snack consumption (p = 0.102). Table 2 Parental Knowledge Regarding Dental Erosion in Relation to Educational Level Variable Education P-value High school or less More than high school What is dental erosion? Teeth decay because of caries 152 (40.64%) 44 (28.95%) 108 (71.05%) 0.002 Erosion because of acids 193 (51.60%) 24 (12.44%) 169 (87.56%) Teeth cracks 11 (2.94%) 3 (27.27%) 8 (72.73%) Teeth discoloration 18 (4.81%) 5 (27.78%) 13 (72.22%) Is dental erosion serious condition? Yes 276 (73.80%) 53 (19.20%) 223 (80.80%) 0.423 No 24 (6.42%) 4 (16.67%) 20 (83.33%) I don’t know 74 (19.79%) 19 (25.68%) 55 (74.32%) Do you think dental erosion can affect your child’s overall health? Yes 317 (84.76%) 60 (18.93%) 257 (81.07%) 0.054 No 16 (4.28%) 2 (12.50%) 14 (87.50%) I don’t know 41 (10.96%) 14 (34.15%) 27 (65.85%) How often do you allow your child to consume acidic drinks? Never 84 (22.46%) 15 (17.86%) 69 (82.14%) 0.005 Rarely (Twice a month) 191 (51.07%) 51 (26.70%) 140 (73.30%) Sometimes (More than 4 times a month) 71 (18.98%) 5 (7.04%) 66 (92.96%) Often (More than 6 times a month) 28 (7.49%) 5 (17.86%) 23 (82.14%) How often does your child eat sugary snacks? Never 9 (2.41%) 3 (33.33%) 6 (66.67%) 0.102 Rarely (Twice a month) 109 (29.14%) 29 (26.61%) 80 (73.39%) Sometimes (More than 4 times a month) 168 (44.92%) 32 (19.05%) 136 (80.95%) Often (More than 6 times a month) 88 (23.53%) 12 (13.64%) 76 (86.36%) Table 3 illustrates the parental concerns and knowledge of prevention and treatment of dental erosion. Most parents expressed concern about dental erosion in their children’s teeth, with 38.2% reporting that they were very worried and 36.4% somewhat worried. When asked whether raising awareness about dental erosion could help reduce its occurrence, 92.8% of parents agreed and the difference by education level was statistically significant (p = 0.04). The parents’ knowledge of preventive measures was relatively high, as 62.3% of parents reported knowledge of methods to prevent erosion. However, awareness of the available treatments was lower; only 30.2% knew of the treatment options. Despite this, almost all the parents (92.8%) agreed on the importance of treating dental erosion in children. In terms of dental visits, slightly more than half of the parents (51.6%) reported taking their children to the dentist only if there was a problem. Preventive visits were less common, with 19.3% reporting annual checkups and 19.5% reporting biannual checkups. Regarding the perceived importance of dental check-ups in preventing erosion, two-thirds of the parents (65.2%) considered them very important. The difference by educational level was statically significant (p = 0.006) Table 3 Parental Concerns and Knowledge of Prevention and Treatment of Dental Erosion by Educational Level Variable Education P-value high school or less More than high school How worried are you about dental erosion in your child’s teeth? Not worried at all 16 (4.28%) 1 (6.25%) 15 (93.75%) 0.397 Neutral 79 (21.12%) 14 (17.72%) 65 (82.28%) Somewhat worried 136 (36.36%) 28 (20.59%) 108 (79.41%) very worried 143 (38.24%) 33 (23.08%) 110 (76.92%) Can raising awareness about dental erosion help reduce it? Yes 347 (92.78%) 67 (19.31%) 280 (80.69%) 0.042 No 7 (1.87%) 4 (57.14%) 3 (42.86%) I don’t know 20 (5.35%) 5 (25.00%) 15 (75.00%) Do you know any methods to prevent dental erosion in children? Yes 233 (62.30%) 50 (21.46%) 183 (78.54%) 0.482 No 141 (37.70%) 26 (18.44%) 115 (81.56%) Do you know the available treatments for dental erosion? Yes 113 (30.21%) 25 (22.12%) 88 (77.88%) 0.569 No 261 (69.79%) 51 (19.54%) 210 (80.46%) is it important to treat tooth erosion in children? Yes 347 (92.78%) 69 (19.88%) 278 (80.12%) 0.739 No 7 (1.87%) 2 (28.57%) 5 (71.43%) I don’t know 20 (5.35%) 5 (25.00%) 15 (75.00%) How often does your child visit the dentist for check-up? Never 36 (9.63%) 9 (25.00%) 27 (75.00%) 0.280 Only if there is a problem. 193 (51.60%) 43 (22.28%) 150 (77.72%) Yearly 72 (19.25%) 15 (20.83%) 57 (79.17%) Twice annually 73 (19.52%) 9 (12.33%) 64 (87.67%) How important do you think regular dental check-ups are in preventing dental erosion? Very important 244 (65.24%) 38 (15.57%) 206 (84.43%) 0.006 Moderately important 125 (33.42%) 36 (28.80%) 89 (71.20%) Not important at all 5 (1.34%) 2 (40.00%) 3 (60.00%) Discussion In this cross-sectional study, the aim was to investigate parental knowledge and preventive practices concerning dental erosion among preschool children in Saudi Arabia. The data showed that (79.9%) of the parents had heard about dental erosion and (20.1%) had not. Around half of the participants identified acids as the primary factor, with a substantial portion of around 40% mistaking erosion with dental caries. Dental erosion is fundamentally a process of chemical dissolution of the tooth structure by acids, not bacteria, which distinguishes it from the bacterial- and sugar-driven processes of caries[1,4]. When parents perceive erosion as a form of tooth decay, their preventive efforts gravitate toward sugar intake reduction and more frequent brushing. This focus overlooks the primary cause which could be intrinsic because of GERD or extrinsic such as the frequent consumption of acidic foods and beverages, for example fruit juices, soft drinks, and sports drinks, which are often mistakenly perceived as healthy alternatives to sugary snacks [6,10]. In addition, around half of the parents identified acid as the cause of dental erosion and the findings show that most parents who had attained education beyond high school were more knowledgeable compared to those with only high school education or less (p = 0.002). This might suggest that education could be a factor in the level of parents’ knowledge regarding dental conditions. The data align with a growing body of literature highlighting the link between parental factors such as education level and children’s oral health outcomes[21–25]. Furthermore, Regarding the seriousness of the condition, 73.8% of the parents identified dental erosion as a serious health issue and 84.8% of parents reported that dental erosion could affect a child’s overall health, when asked about dietary habits, a statistically significant association was observed between educational level and the frequency of allowing children to consume acidic drinks (p = 0.005). On the other hand, no significant association was found between educational level and the frequency of sugary snack consumption. Parental decisions regarding their children's nutrition are complex, multifactorial and influenced by everyday factors however it is important to make sure that the parents understand that certain types of food and drinks have more negative impact on their children oral heath than other types. One suggestion from of the understanding of the presented data is the important of raising awareness of the term “dental erosion.” As a suggestion the strategic focus needs to shift toward a practical understanding. The message must be direct and clearly differentiating erosion from caries with simple statements, such as, “Dental erosion is tooth wear caused by acid, which is different from cavities caused by sugar and germs”. Regarding parental concerns and knowledge of prevention and treatment for dental erosion, 38.2% reported being very worried and 36.4% somewhat worried. Most parents (92.8%) agreed that raising awareness about dental erosion could help reduce its prevalence, and knowledge differed significantly by education level (p = 0.04). While 62.3% of parents reported knowing methods to prevent erosion, only 30.2% were aware of treatment options. Nonetheless, nearly all parents (92.8%) agreed on the importance of treating dental erosion in children. In terms of dental visits, slightly more than half of the parents (51.6%) reported taking their children to the dentist only if there was a problem. Preventive visits were less common, with 19.3% reporting annual checkups and 19.5% reporting biannual checkups. Regarding the perceived importance of dental check-ups in preventing erosion, two-thirds of the parents (65.2%) considered them very important. The difference by educational level was statically significant (p = 0.006). From the presented data we suggest that clinicians could have a critical role to play; for example, the data show that over half of parents seek dental care only in response to a problem such as pain. Thus, clinicians need to use these visits as an opportunity for education and increase the awareness about dental erosion. The fact that few parents were aware of potential treatments for erosion indicates the need for such a chance for education. A few minutes of dedicated chairside counseling, using simple language and visual aids to explain the erosive process, can be impactful. Clinicians can explain the protective role of saliva and provide personalized dietary advice that is practical and empathetic to the challenges of parenting[10,12]. Finally, this study’s strengths include the recruitment of a sample of parents from different areas of Saudi Arabia. Concentrating on parents of preschool children, we targeted a critical developmental window where lifelong dietary and oral hygiene habits were established[22–25]. The use of a culturally adapted and rigorously pilot-tested questionnaire further strengthened the internal validity of the data. Nevertheless, some limitations must be acknowledged. The cross-sectional design of the study allows us to identify associations but precludes the establishment of causality. Furthermore, our reliance on self-reported data increases the possibility of recall bias or social desirability bias, in which respondents may report behaviors they see as more socially acceptable. The survey method may have led to a sample skewed toward parents with higher technological literacy or socioeconomic status. Finally, limiting the sample to Saudi citizens means that the results may not fully represent the experiences of the non-Saudi population living in Saudi Arabia. These methodological aspects are important considerations when interpreting the scope of our conclusions, and they highlight the importance of adhering to reporting guidelines, such as STROBE, to ensure transparency [26]. In conclusion, most parents in the presented sample had heard of dental erosion and agreed that awareness could reduce dental erosion. This research is a foundational platform for future investigations in which a longitudinal study will be conducted to track the incidence of erosion in children and report the effect of it over time on oral health. Conclusion Although many parents in the sample recognized the term “dental erosion,” there is a deficit in understanding its acidic etiology and its distinction from dental caries. Parental education emerged as an important factor influencing knowledge about dental erosion, and many parents reported limited knowledge of available treatment options. Educational level also influenced dental care behaviors. This study provides a foundation for future research, including a planned longitudinal study to track erosion incidence in children and assess its long-term impact on oral health. Declarations Author Contribution Conceptualization: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed BalkhoyorMethodology: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed BalkhoyorData curation: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri.interpretation of data: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed BalkhoyorFormal analysis: Hesham Alhazmi, Ahmed BalkhoyorSupervision: Hesham Alhazmi, Ahmed BalkhoyorCritical revising: Hesham Alhazmi, Ahmed Balkhoyor.Writing – original draft: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed AsiriWriting – review & editing: Hesham Alhazmi, Ahmed Balkhoyor.Authors give final approval: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed Balkhoyor References Schlueter, N.; Amaechi, B.T.; Bartlett, D.; Buzalaf, M.A.R.; Carvalho, T.S.; Ganss, C.; Hara, A.T.; Huysmans, M.-C.D.N.J.M.; Lussi, A.; Moazzez, R.; et al. Terminology of Erosive Tooth Wear: Consensus Report of a Workshop Organized by the ORCA and the Cariology Research Group of the IADR. Caries Res. 2019 , 54 , 2–6, doi:10.1159/000503308. Ganss, C.& L.A. Diagnosis of Erosive Tooth Wear ; KARGER eBooks, 2006; Lussi, A.; Schaffner, M.; Jaeggi, T. Dental Erosion - Diagnosis and Prevention in Children and Adults*. Int. Dent. J. 2007 , 57 , 385–398, doi:https://doi.org/10.1111/j.1875-595X.2007.tb00166.x. Mark, A.M. What Is Dental Erosion? The Journal of the American Dental Association 2018 , 149 , 564, doi:10.1016/j.adaj.2018.04.011. Frazão, J.B.; Machado, L.G.; Ferreira, M.C. Dental Erosion in Schoolchildren and Associated Factors: A Cross-Sectional Study. Journal of Indian Society of Pedodontics and Preventive Dentistry 2018 , 36 . Naswa Friska Nur Sabrina; Made Kania Putri Nirajnani; Tantiana The Risk of Tooth Erosion Due to Consumption of Carbonated Beverages. World Journal of Advanced Research and Review 2025 . Ciavarella, D.; Cazzolla, A.P.; Testa, N.F.; Di Cosola, M.; Ruiz, D.C.; Marqués Martínez, L.; Miralles, E.G. Dental Erosion and Diet in Young Children and Adolescents: A Systematic Review. Applied Sciences 2023, Vol. 13, Page 3519 2023 , 13 , 3519, doi:10.3390/APP13063519. Zimmer, S.; Kirchner, G.; Bizhang, M.; Benedix, M. Influence of Various Acidic Beverages on Tooth Erosion. Evaluation by a New Method. PLoS One 2015 , 10 , e0129462, doi:10.1371/JOURNAL.PONE.0129462. Hara, A.T.; Zero, D.T. The Potential of Saliva in Protecting against Dental Erosion. In; Monogr Oral Sci, 2014; Vol. 25, pp. 197–205. Zero, D.T. Etiology of Dental Erosion – Extrinsic Factors. Eur. J. Oral Sci. 1996 , 104 , 162–177, doi:https://doi.org/10.1111/j.1600-0722.1996.tb00065.x. Buzalaf, M.A.R.; Hannas, A.R.; Kato, M.T. Saliva and Dental Erosion. Journal of Applied Oral Science 2012 , 20 , 493–502, doi:10.1590/S1678-77572012000500001. G. Dipalma; F. Inchingolo; A. Patano; M. Guglielmo; I. Palumbo; M. Campanelli; A.D. Inchingolo; G. Malcangi; A. Palermo; F.C. Tartaglia; et al. Dental Erosion and the Role of Saliva: A Systematic Review. Eur Rev Med Pharmacol Sci 2023 , 27 , 10651–10660. Al-Dlaigan, Y.H.; Al-Meedania, L.A.; Anil, S. The Influence of Frequently Consumed Beverages and Snacks on Dental Erosion among Preschool Children in Saudi Arabia. Nutr. J. 2017 , 16 , 80, doi:10.1186/s12937-017-0307-9. Al-Malik, M.I.; Holt, R.D.; Bedi, R. Erosion, Caries and Rampant Caries in Preschool Children in Jeddah, Saudi Arabia. Community Dent. Oral Epidemiol. 2002 , 30 , 16–23, doi:https://doi.org/10.1034/j.1600-0528.2002.300103.x. Entezami, S.; Peres, K.G.; Li, H.; Albarki, Z.; Hijazi, M.; Ahmed, K.E. Tooth Wear and Socioeconomic Status in Childhood and Adulthood: Findings from a Systematic Review and Meta-Analysis of Observational Studies. E -journal of dentistry 2021 , 115 , doi:10.1016/J.JDENT.2021.103827. Mohammed, Y.S.; Ahmed, T.; Zakirulla, M.; Al-Dheer, A.M.; Al-Futaih, M.A.; Al-Jalal, A.A.; Al-Qahtani, N.S. Dental Erosion among 12-15-Year-Old School Boys in Southern Saudi Arabia. 2013 . Alshammari, F.S.; Alshammari, R.A.; Alshammari, M.H.; Alshammari, M.F.; Alibrahim, A.K.; Al Sineedi, F.A.; Alkurdi, K.A.; Alshammari, A.F. Parental Awareness and Knowledge toward Their Children’s Oral Health in the City of Dammam, Saudi Arabia. Int. J. Clin. Pediatr. Dent. 2021 , 14 , 100, doi:10.5005/JP-JOURNALS-10005-1894. May, J.; Waterhouse, P.J. Dental Erosion and Soft Drinks: A Qualitative Assessment of Knowledge, Attitude and Behaviour Using Focus Groups of Schoolchildren. A Preliminary Study. Int. J. Paediatr. Dent. 2003 , 13 , 425–433, doi:https://doi.org/10.1046/j.1365-263X.2003.00500.x. Nihtyanova, T.; Sapunarova, P.; Belcheva-Krivorova, A.; Petrova, S. Parental Knowledge of Dental Erosion and Erosion-Related Risk Factors in Children. Folia Med. (Plovdiv). 31AD , 63 , 541–545. Al-Majed, I.; Maguire, A.; Murray, J.J. Risk Factors for Dental Erosion in 5–6 Year Old and 12–14 Year Old Boys in Saudi Arabia. Community Dent. Oral Epidemiol. 2002 , 30 , 38–46, doi:10.1034/J.1600-0528.2002.300106.X. Adil, A.H.; Eusufzai, S.Z.; Kamruddin, A.; Wan Ahmad, W.M.A.; Jamayet, N. Bin; Karobari, M.I.; Alam, M.K. Assessment of Parents’ Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children. Children 2020 , 7 , doi:10.3390/children7080101. Adil, A.H.; Eusufzai, S.Z.; Kamruddin, A.; Ahmad, W.M.A.W.; Jamayet, N. Bin; Karobari, M.I.; Alam, M.K. Assessment of Parents’ Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children. Children 2020 , 7 , doi:10.3390/CHILDREN7080101. Emadzadeh, M.; Mirbirjandian, M.; Sistani, M.M.N.; Ravanshad, Y.; Azarfar, A. Association of Children’s Dental Health Status with Their Parents’ Oral Health Literacy and Family Characteristics. Journal of Health Literacy 2021 , 6 , 47–54, doi:10.22038/JHL.2021.60120.1197. Khodadadi, E.; Niknahad, A.; Naghibi Sistani, M.M.; Motallebnejad, M. Parents’ Oral Health Literacy and Its Impact on Their Children’s Dental Health Status. Electron. Physician 2016 , 8 , 3421–3425, doi:10.19082/3421. Hidalgo-Mora, E.; Campos-Campos, K.J.; Gálvez, D.A.; López-Ramos, R.P.; Vidigal, E.A. Parents’ Oral Health Literacy and Its Association with Their Children’s Oral Health: A Review. Revista Científica Odontológica 2024 , 12 , e209, doi:10.21142/2523-2754-1203-2024-209. Elm, E. von; Altman, D.G.; Egger, M.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. BMJ : British Medical Journal 2007 , 335 , 806, doi:10.1136/BMJ.39335.541782.AD. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 30 Apr, 2026 Reviews received at journal 25 Apr, 2026 Reviewers agreed at journal 25 Apr, 2026 Reviewers agreed at journal 24 Apr, 2026 Reviewers invited by journal 22 Apr, 2026 Editor assigned by journal 18 Apr, 2026 Submission checks completed at journal 18 Apr, 2026 First submitted to journal 11 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9390474","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":632726210,"identity":"5ec30299-e384-4bd4-8f92-29ce6d4fedc5","order_by":0,"name":"Saud Shaher Almutairy","email":"","orcid":"","institution":"King Saud bin Abdulaziz University for Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Saud","middleName":"Shaher","lastName":"Almutairy","suffix":""},{"id":632726214,"identity":"339a62c4-9ce1-4b1b-8a16-efe1a4ad9708","order_by":1,"name":"Haneen Mohammed AlAyyaf","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Haneen","middleName":"Mohammed","lastName":"AlAyyaf","suffix":""},{"id":632726217,"identity":"ed082d98-630b-4587-8e30-8303271ac280","order_by":2,"name":"Sara waslullah Alhjajji","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"waslullah","lastName":"Alhjajji","suffix":""},{"id":632726219,"identity":"fe5a829f-cb7e-4fc8-940b-13c69fdb3172","order_by":3,"name":"Abdulmohsen Mohammed Albraheem","email":"","orcid":"","institution":"King Faisal University","correspondingAuthor":false,"prefix":"","firstName":"Abdulmohsen","middleName":"Mohammed","lastName":"Albraheem","suffix":""},{"id":632726221,"identity":"e342614f-8e17-420d-9a9a-fb1eb39bd6d8","order_by":4,"name":"Shatha Abdullah Alenazi","email":"","orcid":"","institution":"Majmaah University","correspondingAuthor":false,"prefix":"","firstName":"Shatha","middleName":"Abdullah","lastName":"Alenazi","suffix":""},{"id":632726228,"identity":"3311be5b-e02e-4ae7-b431-0268bb139a20","order_by":5,"name":"Aryaf Kairallah Almutairi","email":"","orcid":"","institution":"Majmaah University","correspondingAuthor":false,"prefix":"","firstName":"Aryaf","middleName":"Kairallah","lastName":"Almutairi","suffix":""},{"id":632726229,"identity":"eff4eafa-75fa-4be9-a93f-7307c5defbe2","order_by":6,"name":"Iman Hilal AlSukaiti","email":"","orcid":"","institution":"Oman Dental College","correspondingAuthor":false,"prefix":"","firstName":"Iman","middleName":"Hilal","lastName":"AlSukaiti","suffix":""},{"id":632726231,"identity":"2b0923f7-41e4-4770-9217-a80d276b77ee","order_by":7,"name":"Adel Mohammed Asiri","email":"","orcid":"","institution":"King Saud bin Abdulaziz University for Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Adel","middleName":"Mohammed","lastName":"Asiri","suffix":""},{"id":632726232,"identity":"3690605f-c209-4656-a29a-2bbc2b604d1a","order_by":8,"name":"Hesham Alhazmi","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Hesham","middleName":"","lastName":"Alhazmi","suffix":""},{"id":632726233,"identity":"de739616-19c1-490b-a4a1-0601c2965d77","order_by":9,"name":"Ahmed Mohammed Balkhoyor","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+0lEQVRIiWNgGAWjYFACHgaGBwcOgFiMDyAiCURoSYBoYTYgWQubBFFa+KedPfgh4cwdOYPjvc+qecoOM/Cz5xgw/qjBrUXidl6yRMKNZ8YGZ46b3eY5d5hBsueNATPPMTzW3M4xkEj4cDhxw400ttu8bYcZDG7kGDAzsOHWIX87x/gHTEsxSIv9DZDD/uHWYnA7xwzoMIgWZrAtEjkGDLxtuLUY3s5Ls0g4c9hY8swxZsk559J5JM48KzjM24dbi9zt3MM3Phw7LMd3vI3xw5syazn+9uSND398w+N9GFA4ACLZQNHEwHCACA3AcGiAaBkFo2AUjIJRgAEAat5acGAD3RcAAAAASUVORK5CYII=","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":true,"prefix":"","firstName":"Ahmed","middleName":"Mohammed","lastName":"Balkhoyor","suffix":""}],"badges":[],"createdAt":"2026-04-11 20:53:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9390474/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9390474/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108803833,"identity":"d8ee6c0b-872d-49f8-a11a-549323f39d16","added_by":"auto","created_at":"2026-05-08 15:08:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":427120,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9390474/v1/c10d1bc8-428d-40de-bbd8-ff18c2a82f03.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Parental Knowledge of Dental Erosion and Erosion-Related Risk Factors in Children in various regions of Saudi Arabia.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDental erosion is characterized by the chemical deterioration of the hard tooth structure resulting from exposure to acids of nonbacterial origin [1]. In its initial stages, erosive tooth wear typically presents as a smooth, silky, glazed appearance on the enamel surface [2]. Changes in tooth morphology become more noticeable as the disease progresses[2]. The development of cavities or grooves on the occlusal surfaces, loss of perikymata, and the presence of intact enamel near the gingival margin are typical clinical signs[3]. Because of their subtlety, lack of obvious symptoms, and ease of overlooking during clinical examination, these early manifestations often lead to delayed diagnosis and intervention [3].\u003c/p\u003e \u003cp\u003eTooth erosion may occur because of acids of intrinsic origin, such as those associated with gastroesophageal reflux disease (GERD), where stomach acid enters the oral cavity through voluntary or involuntary reflux episodes[4,5]. Furthermore, erosive tooth wear is largely caused by extrinsic factors, especially the frequent consumption of acidic foods and drinks. For example, regular consumption of fruit juices, soft drinks, and citrus fruits has been closely associated with a higher risk of erosion [4,5]. An important factor influencing erosive potential is the pH level at the tooth surface after consuming an acidic beverage. Citric, phosphoric, ascorbic, malic, and carbonic acids are common dietary acids linked to dental erosion; citric acid has a significantly higher erosive potential than the others[3\u0026ndash;5].\u003c/p\u003e \u003cp\u003eThe progression of erosion is influenced by several factors that can be prevented or at least controlled. These factors include lifestyle, dental prevention care, and overall health. Over the past 10 years, the number of people with tooth erosion has increased, likely due to the increased consumption of acidic beverages, such as soft drinks and fruit juices[6]. This is particularly true for children and adolescents, who tend to drink more acidic beverages than adults [6,7]. Many factors affect the severity of erosion. The type of acid, how long it remains on the tooth, and other ingredients in the beverage all play a role. For example, if a beverage contains calcium, phosphate, or fluoride, it may help protect the tooth. However, if the beverage is highly acidic and remains on the tooth for a long time, it increases the likelihood of enamel erosion. Other factors, such as the amount of saliva a person produces, their oral hygiene, and the type of food they eat, also play a role in the development and severity of tooth erosion [6\u0026ndash;8].\u003c/p\u003e \u003cp\u003eSaliva is one of the most important factors contributing to preventing tooth erosion [9]. It does this by producing a protective layer, reducing acids on the tooth surface, cleaning and neutralizing them, and combating the factors that cause erosion [9,10]. Saliva is essential to prevent the demineralization of tooth enamel and to promote remineralization processes due to its richness in minerals[9,11]. Saliva also helps patients with GERD maintain balance in the digestive system and oral cavity[12]. Reduced saliva flow, commonly referred to as xerostomia, significantly weakens these protective mechanisms, increasing teeth\u0026rsquo;s vulnerability to erosive damage [12]. The importance of these risk factors has been well established in population-based studies conducted in Saudi Arabia. For instance, a study by Al-Dlagian et al. of 388 children in Riyadh found that 47% had mild erosion, 10% had moderate erosion, and 4% had severe erosion. Notably, 60% of the participants reported regularly consuming juice drinks, and of these, 84% showed signs of erosion. This indicates a strong and statistically significant association (p\u0026thinsp;\u0026lt;\u0026thinsp;0.005) between daily juice consumption and the prevalence of erosion. Furthermore, the study highlighted another behavioral risk factor, holding liquids in the mouth before swallowing, which also showed a significant association with erosion incidence (p\u0026thinsp;\u0026lt;\u0026thinsp;0.02) [13].\u003c/p\u003e \u003cp\u003eThese findings provide experimental support for the role of the frequency of acidic beverage consumption and behavioral patterns in accelerating tooth enamel degradation. A similar result was seen in a study by Al-Malik et al. a clinical examination of 987 children showed that 31% had tooth loss affecting the labial and/or palatal surfaces of the upper incisors. These lesions have been attributed, in whole or in part, to erosive processes[14]. The localized pattern of tissue loss is consistent with exposure to dietary acids and is in line with the mechanisms discussed previously, such as the duration of acid contact and tooth surface sensitivity. These studies show that dental erosion could be common among Saudi children and show how important it is to change lifestyle and eating habits at the individual and community levels[13\u0026ndash;17]. Studies have indicated that parents continue to have an influence on their children aged 8 to 9 years and are the primary influencer of this age group\u0026rsquo;s beverage choices [18,19]. The primary aim of this study was to assess parental knowledge regarding dental erosion and its associated risk factors of children aged 3\u0026ndash;6 years in Saudi Arabia.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis cross-sectional study was conducted to evaluate parental knowledge regarding dental erosion and its associated risk factors among parents of preschool children aged 3\u0026ndash;6 years in Saudi Arabia. The data collection period extended from August to December 2024. The data were collected using a structured self-administered questionnaire distributed to the parents visiting pediatric dentistry clinics in several regions across Saudi Arabia digitally through messaging platforms (particularly WhatsApp and Telegram). A convenient sampling technique was used, and participation in the study was entirely voluntary. All participants provided informed consent prior to completing the questionnaire. Responses were anonymous and treated with strict confidentiality. The study protocol was reviewed and approved by the Institutional Review Board (IRB) of Umm Al-Qura University, Makkah, Saudi Arabia, with IRB approval number HAPO-02-K-012-2025-02-2529.\u003c/p\u003e \u003cp\u003eThe target population of this study consisted of parents of preschool children in Saudi Arabia. The required sample size was calculated using a 95% confidence level and a 5% margin of error. Based on this, a minimum sample size of 385 was estimated. Inclusion criteria were being Saudi nationals and parents of at least one child in preschool aged 3\u0026ndash;6 years. The exclusion criteria were non-Saudi parents and parents who have children that didn\u0026rsquo;t fall within the preschool age group.\u003c/p\u003e \u003cp\u003eThe questionnaire was adapted from previously validated instruments and modified to suit the Saudi cultural and linguistic context [19,20]. It was written in Arabic and underwent a pilot test with a small group of parents to ensure clarity and relevance. Minor revisions were made based on their feedback. The first section of the questionnaire consisted of demographic information, which included questions on the parents\u0026rsquo; age, gender, marital status, nationality, region of residence, educational level, employment status, monthly income, and number of children. The second section included questions about knowledge of dental erosion and its risk factors. The third section included questions about the prevention and management of dental erosion.\u003c/p\u003e \u003cp\u003eDescriptive statistics (frequencies and percentages) were used to summarize the data. A chi-square test was applied to examine the associations between the categorical variables. A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant. All statistical analyses were conducted using STATA software, version 18.0.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the distribution of demographic data in relation to parents heard about dental erosion. Of the 396 respondents, 299 (79.9%) had heard of dental erosion, while 75 (20.1%) had not. This did not differ significantly by gender (p\u0026thinsp;=\u0026thinsp;0.205), with 82.8% of males and 77.5% of females reporting prior knowledge of the term dental erosion. Across age groups, it was relatively consistent, ranging from 75.6% among those aged 46\u0026ndash;50 years to 82.7% among those aged 20\u0026ndash;25 years, with no significant differences observed (p\u0026thinsp;=\u0026thinsp;0.835). Educational level also showed no significant association (p\u0026thinsp;=\u0026thinsp;0.376), although parents with more than a high school education reported slightly higher (80.9%) compared to those with a high school education or less (76.3%). Regional distribution revealed that the participants from the south (92.9%) heard about the term erosion more than those from the east (76.4%), but these differences were not statistically significant (p\u0026thinsp;=\u0026thinsp;0.440). Regarding family size, parents with only one child reported the highest level (88.3%), while those with four children showed the lowest (72.9%), although this trend was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.245). Similarly, no significant differences were observed across employment status (p\u0026thinsp;=\u0026thinsp;0.766) or marital status (p\u0026thinsp;=\u0026thinsp;0.169). In terms of income, which ranged from 74.0% among parents earning 10,000\u0026ndash;15,000 SAR to 88.1% among those earning 15,000\u0026ndash;20,000 SAR, with no significant differences (p\u0026thinsp;=\u0026thinsp;0.453).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic Variables and Knowledge of Dental Erosion Among Parents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDemographic variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eHeard of dental erosion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e299 (79.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75 (20.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e181 (45.71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144 (82.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (17.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.205\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e215 (54.29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e155 (77.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 (22.50%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 (20.71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (82.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (17.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.835\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160 (40.40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120 (79.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (20.53%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e36\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 (28.54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86 (80.37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (19.63%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e46\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41 (10.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (75.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (24.39%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehigh school or less\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93 (23.48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58 (76.32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (23.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.376\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e303 (76.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e241 (80.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57 (19.13%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112 (28.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84 (84.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (16.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.440\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200 (50.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149 (77.60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (22.40%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55 (13.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (76.36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (23.64%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNorth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (3.54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (84.62%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (15.38%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (3.79%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (92.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (7.14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow many kids in the family\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOne kid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (15.40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (88.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (11.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTwo kids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101 (25.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (77.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (22.11%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThree kids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89 (22.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (83.13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (16.87%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFour kids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (16.16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (72.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (27.12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 4 kids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81 (20.45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (77.92%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (22.08%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153 (38.64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115 (82.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (17.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.766\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e204 (51.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156 (78.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (22.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (8.08%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (80.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (20.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (1.77%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (80.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (20.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e354 (89.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e268 (80.48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65 (19.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (8.08%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (80.65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (19.35%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (2.02%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (50.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (50.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (0.51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome in Saudi Riyal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eless than 5 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e143 (36.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98 (79.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (20.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e105 (26.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85 (81.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (18.27%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;15 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (19.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (74.03%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (25.97%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;20 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (10.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (88.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (11.90%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 20 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (7.32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (78.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (21.43%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates parental knowledge regarding dental erosion in relation to educational level. More than half of the parents correctly identified dental erosion as being caused by acids (51.6%), with a higher proportion among those with more than high school education (87.6%) compared to the lower education group (12.4%). Around 40.6% of parents thought dental erosion was due to dental caries, while smaller proportions attributed it to tooth cracks (2.9%) or discoloration (4.8%). A p-value of (0.002) indicates that the understanding of what dental erosion is varied significantly based on the education level of the participants. Regarding the seriousness of the condition, 73.8% of the parents recognized dental erosion as a serious health issue, with no significant difference in educational levels (p\u0026thinsp;=\u0026thinsp;0.423). Similarly, 84.8% of parents reported that dental erosion could affect a child\u0026rsquo;s overall health, although the difference between the groups was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.054). When asked about dietary habits, a statistically significant association was observed between educational level and the frequency of allowing children to consume acidic drinks (p\u0026thinsp;=\u0026thinsp;0.005). On the other hand, no significant association was found between educational level and the frequency of sugary snack consumption (p\u0026thinsp;=\u0026thinsp;0.102).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParental Knowledge Regarding Dental Erosion in Relation to Educational Level\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh school or less\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMore than high school\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhat is dental erosion?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth decay because of caries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152 (40.64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (28.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108 (71.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eErosion because of acids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e193 (51.60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (12.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e169 (87.56%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth cracks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (2.94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (27.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (72.73%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth discoloration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (4.81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (27.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (72.22%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIs dental erosion serious condition?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e276 (73.80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (19.20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e223 (80.80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.423\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (6.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (16.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (83.33%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74 (19.79%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (25.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55 (74.32%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you think dental erosion can affect your child\u0026rsquo;s overall health?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e317 (84.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (18.93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e257 (81.07%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (4.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (12.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (87.50%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41 (10.96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (34.15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (65.85%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow often do you allow your child to consume acidic drinks?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (22.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (17.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69 (82.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRarely (Twice a month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e191 (51.07%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (26.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e140 (73.30%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes (More than 4 times a month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (18.98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (7.04%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66 (92.96%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOften (More than 6 times a month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (7.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (17.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (82.14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow often does your child eat sugary snacks?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (2.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (33.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (66.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRarely (Twice a month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e109 (29.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (26.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80 (73.39%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes (More than 4 times a month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e168 (44.92%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (19.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e136 (80.95%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOften (More than 6 times a month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88 (23.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (13.64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76 (86.36%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates the parental concerns and knowledge of prevention and treatment of dental erosion. Most parents expressed concern about dental erosion in their children\u0026rsquo;s teeth, with 38.2% reporting that they were very worried and 36.4% somewhat worried. When asked whether raising awareness about dental erosion could help reduce its occurrence, 92.8% of parents agreed and the difference by education level was statistically significant (p\u0026thinsp;=\u0026thinsp;0.04). The parents\u0026rsquo; knowledge of preventive measures was relatively high, as 62.3% of parents reported knowledge of methods to prevent erosion. However, awareness of the available treatments was lower; only 30.2% knew of the treatment options. Despite this, almost all the parents (92.8%) agreed on the importance of treating dental erosion in children. In terms of dental visits, slightly more than half of the parents (51.6%) reported taking their children to the dentist only if there was a problem. Preventive visits were less common, with 19.3% reporting annual checkups and 19.5% reporting biannual checkups. Regarding the perceived importance of dental check-ups in preventing erosion, two-thirds of the parents (65.2%) considered them very important. The difference by educational level was statically significant (p\u0026thinsp;=\u0026thinsp;0.006)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParental Concerns and Knowledge of Prevention and Treatment of Dental Erosion by Educational Level\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ehigh school or less\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMore than high school\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow worried are you about dental erosion in your child\u0026rsquo;s teeth?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot worried at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (4.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (6.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (93.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79 (21.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (17.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65 (82.28%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomewhat worried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136 (36.36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (20.59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108 (79.41%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003every worried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e143 (38.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (23.08%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e110 (76.92%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCan raising awareness about dental erosion help reduce it?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e347 (92.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (19.31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e280 (80.69%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (1.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (57.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (42.86%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (5.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (25.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (75.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you know any methods to prevent dental erosion in children?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e233 (62.30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (21.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183 (78.54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.482\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e141 (37.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (18.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115 (81.56%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you know the available treatments for dental erosion?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 (30.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (22.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88 (77.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.569\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e261 (69.79%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (19.54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e210 (80.46%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eis it important to treat tooth erosion in children?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e347 (92.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (19.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e278 (80.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.739\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (1.87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (28.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (71.43%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (5.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (25.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (75.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow often does your child visit the dentist for check-up?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (9.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (25.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (75.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.280\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnly if there is a problem.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e193 (51.60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (22.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e150 (77.72%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYearly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (19.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (20.83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57 (79.17%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTwice annually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (19.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (12.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64 (87.67%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow important do you think regular dental check-ups are in preventing dental erosion?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e244 (65.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38 (15.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e206 (84.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerately important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e125 (33.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (28.80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89 (71.20%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot important at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (1.34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (40.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (60.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this cross-sectional study, the aim was to investigate parental knowledge and preventive practices concerning dental erosion among preschool children in Saudi Arabia. The data showed that (79.9%) of the parents had heard about dental erosion and (20.1%) had not. Around half of the participants identified acids as the primary factor, with a substantial portion of around 40% mistaking erosion with dental caries. Dental erosion is fundamentally a process of chemical dissolution of the tooth structure by acids, not bacteria, which distinguishes it from the bacterial- and sugar-driven processes of caries[1,4]. When parents perceive erosion as a form of tooth decay, their preventive efforts gravitate toward sugar intake reduction and more frequent brushing. This focus overlooks the primary cause which could be intrinsic because of GERD or extrinsic such as the frequent consumption of acidic foods and beverages, for example fruit juices, soft drinks, and sports drinks, which are often mistakenly perceived as healthy alternatives to sugary snacks [6,10]. In addition, around half of the parents identified acid as the cause of dental erosion and the findings show that most parents who had attained education beyond high school were more knowledgeable compared to those with only high school education or less (p\u0026thinsp;=\u0026thinsp;0.002). This might suggest that education could be a factor in the level of parents\u0026rsquo; knowledge regarding dental conditions. The data align with a growing body of literature highlighting the link between parental factors such as education level and children\u0026rsquo;s oral health outcomes[21\u0026ndash;25].\u003c/p\u003e \u003cp\u003eFurthermore, Regarding the seriousness of the condition, 73.8% of the parents identified dental erosion as a serious health issue and 84.8% of parents reported that dental erosion could affect a child\u0026rsquo;s overall health, when asked about dietary habits, a statistically significant association was observed between educational level and the frequency of allowing children to consume acidic drinks (p\u0026thinsp;=\u0026thinsp;0.005). On the other hand, no significant association was found between educational level and the frequency of sugary snack consumption. Parental decisions regarding their children's nutrition are complex, multifactorial and influenced by everyday factors however it is important to make sure that the parents understand that certain types of food and drinks have more negative impact on their children oral heath than other types. One suggestion from of the understanding of the presented data is the important of raising awareness of the term \u0026ldquo;dental erosion.\u0026rdquo; As a suggestion the strategic focus needs to shift toward a practical understanding. The message must be direct and clearly differentiating erosion from caries with simple statements, such as, \u0026ldquo;Dental erosion is tooth wear caused by acid, which is different from cavities caused by sugar and germs\u0026rdquo;. Regarding parental concerns and knowledge of prevention and treatment for dental erosion, 38.2% reported being very worried and 36.4% somewhat worried. Most parents (92.8%) agreed that raising awareness about dental erosion could help reduce its prevalence, and knowledge differed significantly by education level (p\u0026thinsp;=\u0026thinsp;0.04). While 62.3% of parents reported knowing methods to prevent erosion, only 30.2% were aware of treatment options. Nonetheless, nearly all parents (92.8%) agreed on the importance of treating dental erosion in children.\u003c/p\u003e \u003cp\u003eIn terms of dental visits, slightly more than half of the parents (51.6%) reported taking their children to the dentist only if there was a problem. Preventive visits were less common, with 19.3% reporting annual checkups and 19.5% reporting biannual checkups. Regarding the perceived importance of dental check-ups in preventing erosion, two-thirds of the parents (65.2%) considered them very important. The difference by educational level was statically significant (p\u0026thinsp;=\u0026thinsp;0.006). From the presented data we suggest that clinicians could have a critical role to play; for example, the data show that over half of parents seek dental care only in response to a problem such as pain. Thus, clinicians need to use these visits as an opportunity for education and increase the awareness about dental erosion. The fact that few parents were aware of potential treatments for erosion indicates the need for such a chance for education. A few minutes of dedicated chairside counseling, using simple language and visual aids to explain the erosive process, can be impactful. Clinicians can explain the protective role of saliva and provide personalized dietary advice that is practical and empathetic to the challenges of parenting[10,12].\u003c/p\u003e \u003cp\u003eFinally, this study\u0026rsquo;s strengths include the recruitment of a sample of parents from different areas of Saudi Arabia. Concentrating on parents of preschool children, we targeted a critical developmental window where lifelong dietary and oral hygiene habits were established[22\u0026ndash;25]. The use of a culturally adapted and rigorously pilot-tested questionnaire further strengthened the internal validity of the data. Nevertheless, some limitations must be acknowledged. The cross-sectional design of the study allows us to identify associations but precludes the establishment of causality. Furthermore, our reliance on self-reported data increases the possibility of recall bias or social desirability bias, in which respondents may report behaviors they see as more socially acceptable. The survey method may have led to a sample skewed toward parents with higher technological literacy or socioeconomic status. Finally, limiting the sample to Saudi citizens means that the results may not fully represent the experiences of the non-Saudi population living in Saudi Arabia. These methodological aspects are important considerations when interpreting the scope of our conclusions, and they highlight the importance of adhering to reporting guidelines, such as STROBE, to ensure transparency [26]. In conclusion, most parents in the presented sample had heard of dental erosion and agreed that awareness could reduce dental erosion. This research is a foundational platform for future investigations in which a longitudinal study will be conducted to track the incidence of erosion in children and report the effect of it over time on oral health.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAlthough many parents in the sample recognized the term \u0026ldquo;dental erosion,\u0026rdquo; there is a deficit in understanding its acidic etiology and its distinction from dental caries. Parental education emerged as an important factor influencing knowledge about dental erosion, and many parents reported limited knowledge of available treatment options. Educational level also influenced dental care behaviors. This study provides a foundation for future research, including a planned longitudinal study to track erosion incidence in children and assess its long-term impact on oral health.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualization: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed BalkhoyorMethodology: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed BalkhoyorData curation: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri.interpretation of data: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed BalkhoyorFormal analysis: Hesham Alhazmi, Ahmed BalkhoyorSupervision: Hesham Alhazmi, Ahmed BalkhoyorCritical revising: Hesham Alhazmi, Ahmed Balkhoyor.Writing \u0026ndash; original draft: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed AsiriWriting \u0026ndash; review \u0026amp; editing: Hesham Alhazmi, Ahmed Balkhoyor.Authors give final approval: Saud Shaher Almutairy, Haneen Mohammed al Ayyaf, Sara waslullah alhjajji, Abdulmohsen Mohammed Albraheem, Shatha Abdullah Alenazi, Aryaf Kairallah Almutairi, Iman Hilal AlSukaiti, Adel Mohammed Asiri, Hesham Alhazmi, Ahmed Balkhoyor\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSchlueter, N.; Amaechi, B.T.; Bartlett, D.; Buzalaf, M.A.R.; Carvalho, T.S.; Ganss, C.; Hara, A.T.; Huysmans, M.-C.D.N.J.M.; Lussi, A.; Moazzez, R.; et al. Terminology of Erosive Tooth Wear: Consensus Report of a Workshop Organized by the ORCA and the Cariology Research Group of the IADR. \u003cem\u003eCaries Res.\u003c/em\u003e \u003cb\u003e2019\u003c/b\u003e, \u003cem\u003e54\u003c/em\u003e, 2\u0026ndash;6, doi:10.1159/000503308.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGanss, C.\u0026amp; L.A. \u003cem\u003eDiagnosis of Erosive Tooth Wear\u003c/em\u003e; KARGER eBooks, 2006;\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLussi, A.; Schaffner, M.; Jaeggi, T. Dental Erosion - Diagnosis and Prevention in Children and Adults*. \u003cem\u003eInt. Dent. J.\u003c/em\u003e \u003cb\u003e2007\u003c/b\u003e, \u003cem\u003e57\u003c/em\u003e, 385\u0026ndash;398, doi:https://doi.org/10.1111/j.1875-595X.2007.tb00166.x.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMark, A.M. What Is Dental Erosion? \u003cem\u003eThe Journal of the American Dental Association\u003c/em\u003e \u003cb\u003e2018\u003c/b\u003e, \u003cem\u003e149\u003c/em\u003e, 564, doi:10.1016/j.adaj.2018.04.011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFraz\u0026atilde;o, J.B.; Machado, L.G.; Ferreira, M.C. Dental Erosion in Schoolchildren and Associated Factors: A Cross-Sectional Study. \u003cem\u003eJournal of Indian Society of Pedodontics and Preventive Dentistry\u003c/em\u003e \u003cb\u003e2018\u003c/b\u003e, \u003cem\u003e36\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaswa Friska Nur Sabrina; Made Kania Putri Nirajnani; Tantiana The Risk of Tooth Erosion Due to Consumption of Carbonated Beverages. \u003cem\u003eWorld Journal of Advanced Research and Review\u003c/em\u003e \u003cb\u003e2025\u003c/b\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCiavarella, D.; Cazzolla, A.P.; Testa, N.F.; Di Cosola, M.; Ruiz, D.C.; Marqu\u0026eacute;s Mart\u0026iacute;nez, L.; Miralles, E.G. Dental Erosion and Diet in Young Children and Adolescents: A Systematic Review. \u003cem\u003eApplied Sciences 2023, Vol. 13, Page 3519\u003c/em\u003e \u003cb\u003e2023\u003c/b\u003e, \u003cem\u003e13\u003c/em\u003e, 3519, doi:10.3390/APP13063519.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZimmer, S.; Kirchner, G.; Bizhang, M.; Benedix, M. Influence of Various Acidic Beverages on Tooth Erosion. Evaluation by a New Method. \u003cem\u003ePLoS One\u003c/em\u003e \u003cb\u003e2015\u003c/b\u003e, \u003cem\u003e10\u003c/em\u003e, e0129462, doi:10.1371/JOURNAL.PONE.0129462.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHara, A.T.; Zero, D.T. The Potential of Saliva in Protecting against Dental Erosion. In; Monogr Oral Sci, 2014; Vol. 25, pp. 197\u0026ndash;205.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZero, D.T. Etiology of Dental Erosion \u0026ndash; Extrinsic Factors. \u003cem\u003eEur. J. Oral Sci.\u003c/em\u003e \u003cb\u003e1996\u003c/b\u003e, \u003cem\u003e104\u003c/em\u003e, 162\u0026ndash;177, doi:https://doi.org/10.1111/j.1600-0722.1996.tb00065.x.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBuzalaf, M.A.R.; Hannas, A.R.; Kato, M.T. Saliva and Dental Erosion. \u003cem\u003eJournal of Applied Oral Science\u003c/em\u003e \u003cb\u003e2012\u003c/b\u003e, \u003cem\u003e20\u003c/em\u003e, 493\u0026ndash;502, doi:10.1590/S1678-77572012000500001.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eG. Dipalma; F. Inchingolo; A. Patano; M. Guglielmo; I. Palumbo; M. Campanelli; A.D. Inchingolo; G. Malcangi; A. Palermo; F.C. Tartaglia; et al. Dental Erosion and the Role of Saliva: A Systematic Review. \u003cem\u003eEur Rev Med Pharmacol Sci\u003c/em\u003e \u003cb\u003e2023\u003c/b\u003e, \u003cem\u003e27\u003c/em\u003e, 10651\u0026ndash;10660.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Dlaigan, Y.H.; Al-Meedania, L.A.; Anil, S. The Influence of Frequently Consumed Beverages and Snacks on Dental Erosion among Preschool Children in Saudi Arabia. \u003cem\u003eNutr. J.\u003c/em\u003e \u003cb\u003e2017\u003c/b\u003e, \u003cem\u003e16\u003c/em\u003e, 80, doi:10.1186/s12937-017-0307-9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Malik, M.I.; Holt, R.D.; Bedi, R. Erosion, Caries and Rampant Caries in Preschool Children in Jeddah, Saudi Arabia. \u003cem\u003eCommunity Dent. Oral Epidemiol.\u003c/em\u003e \u003cb\u003e2002\u003c/b\u003e, \u003cem\u003e30\u003c/em\u003e, 16\u0026ndash;23, doi:https://doi.org/10.1034/j.1600-0528.2002.300103.x.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEntezami, S.; Peres, K.G.; Li, H.; Albarki, Z.; Hijazi, M.; Ahmed, K.E. Tooth Wear and Socioeconomic Status in Childhood and Adulthood: Findings from a Systematic Review and Meta-Analysis of Observational Studies. \u003cem\u003eE -journal of dentistry\u003c/em\u003e \u003cb\u003e2021\u003c/b\u003e, \u003cem\u003e115\u003c/em\u003e, doi:10.1016/J.JDENT.2021.103827.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammed, Y.S.; Ahmed, T.; Zakirulla, M.; Al-Dheer, A.M.; Al-Futaih, M.A.; Al-Jalal, A.A.; Al-Qahtani, N.S. Dental Erosion among 12-15-Year-Old School Boys in Southern Saudi Arabia. \u003cb\u003e2013\u003c/b\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlshammari, F.S.; Alshammari, R.A.; Alshammari, M.H.; Alshammari, M.F.; Alibrahim, A.K.; Al Sineedi, F.A.; Alkurdi, K.A.; Alshammari, A.F. Parental Awareness and Knowledge toward Their Children\u0026rsquo;s Oral Health in the City of Dammam, Saudi Arabia. \u003cem\u003eInt. J. Clin. Pediatr. Dent.\u003c/em\u003e \u003cb\u003e2021\u003c/b\u003e, \u003cem\u003e14\u003c/em\u003e, 100, doi:10.5005/JP-JOURNALS-10005-1894.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMay, J.; Waterhouse, P.J. Dental Erosion and Soft Drinks: A Qualitative Assessment of Knowledge, Attitude and Behaviour Using Focus Groups of Schoolchildren. A Preliminary Study. \u003cem\u003eInt. J. Paediatr. Dent.\u003c/em\u003e \u003cb\u003e2003\u003c/b\u003e, \u003cem\u003e13\u003c/em\u003e, 425\u0026ndash;433, doi:https://doi.org/10.1046/j.1365-263X.2003.00500.x.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNihtyanova, T.; Sapunarova, P.; Belcheva-Krivorova, A.; Petrova, S. Parental Knowledge of Dental Erosion and Erosion-Related Risk Factors in Children. \u003cem\u003eFolia Med. (Plovdiv).\u003c/em\u003e \u003cb\u003e31AD\u003c/b\u003e, \u003cem\u003e63\u003c/em\u003e, 541\u0026ndash;545.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Majed, I.; Maguire, A.; Murray, J.J. Risk Factors for Dental Erosion in 5\u0026ndash;6 Year Old and 12\u0026ndash;14 Year Old Boys in Saudi Arabia. \u003cem\u003eCommunity Dent. Oral Epidemiol.\u003c/em\u003e \u003cb\u003e2002\u003c/b\u003e, \u003cem\u003e30\u003c/em\u003e, 38\u0026ndash;46, doi:10.1034/J.1600-0528.2002.300106.X.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdil, A.H.; Eusufzai, S.Z.; Kamruddin, A.; Wan Ahmad, W.M.A.; Jamayet, N. Bin; Karobari, M.I.; Alam, M.K. Assessment of Parents\u0026rsquo; Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children. \u003cem\u003eChildren\u003c/em\u003e \u003cb\u003e2020\u003c/b\u003e, \u003cem\u003e7\u003c/em\u003e, doi:10.3390/children7080101.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdil, A.H.; Eusufzai, S.Z.; Kamruddin, A.; Ahmad, W.M.A.W.; Jamayet, N. Bin; Karobari, M.I.; Alam, M.K. Assessment of Parents\u0026rsquo; Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children. \u003cem\u003eChildren\u003c/em\u003e \u003cb\u003e2020\u003c/b\u003e, \u003cem\u003e7\u003c/em\u003e, doi:10.3390/CHILDREN7080101.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEmadzadeh, M.; Mirbirjandian, M.; Sistani, M.M.N.; Ravanshad, Y.; Azarfar, A. Association of Children\u0026rsquo;s Dental Health Status with Their Parents\u0026rsquo; Oral Health Literacy and Family Characteristics. \u003cem\u003eJournal of Health Literacy\u003c/em\u003e \u003cb\u003e2021\u003c/b\u003e, \u003cem\u003e6\u003c/em\u003e, 47\u0026ndash;54, doi:10.22038/JHL.2021.60120.1197.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhodadadi, E.; Niknahad, A.; Naghibi Sistani, M.M.; Motallebnejad, M. Parents\u0026rsquo; Oral Health Literacy and Its Impact on Their Children\u0026rsquo;s Dental Health Status. \u003cem\u003eElectron. Physician\u003c/em\u003e \u003cb\u003e2016\u003c/b\u003e, \u003cem\u003e8\u003c/em\u003e, 3421\u0026ndash;3425, doi:10.19082/3421.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHidalgo-Mora, E.; Campos-Campos, K.J.; G\u0026aacute;lvez, D.A.; L\u0026oacute;pez-Ramos, R.P.; Vidigal, E.A. Parents\u0026rsquo; Oral Health Literacy and Its Association with Their Children\u0026rsquo;s Oral Health: A Review. \u003cem\u003eRevista Cient\u0026iacute;fica Odontol\u0026oacute;gica\u003c/em\u003e \u003cb\u003e2024\u003c/b\u003e, \u003cem\u003e12\u003c/em\u003e, e209, doi:10.21142/2523-2754-1203-2024-209.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eElm, E. von; Altman, D.G.; Egger, M.; Pocock, S.J.; G\u0026oslash;tzsche, P.C.; Vandenbroucke, J.P. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. \u003cem\u003eBMJ : British Medical Journal\u003c/em\u003e \u003cb\u003e2007\u003c/b\u003e, \u003cem\u003e335\u003c/em\u003e, 806, doi:10.1136/BMJ.39335.541782.AD.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-umm-alqura-university-for-medical-science","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Umm Al-Qura University for Medical Science](https://link.springer.com/journal/44361)","snPcode":"44361","submissionUrl":"https://submission.springernature.com/new-submission/44361/3","title":"Journal of Umm Al-Qura University for Medical Science","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Parental knowledge, dental erosion, erosion-related risk, acid effect, parent education","lastPublishedDoi":"10.21203/rs.3.rs-9390474/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9390474/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eDental erosion, a growing concern among children in Saudi Arabia, involves the chemical degradation of tooth enamel due to nonbacterial acids. This study focuses on assessing parental knowledge regarding dental erosion and its risk factors.\u003c/p\u003e\u003ch2\u003eMethodology:\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted using a structured Arabic-language questionnaire distributed online. Data from 396 parents of preschool children (aged 3\u0026ndash;6 years) from different regions in Saudi Arabia were collected through convenient sampling via social media messaging platforms. Descriptive analyses were performed and counts and percentages were reported. Chi-square tests were conducted.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the participants, 80% had heard of dental erosion. However, only 51.6% correctly identified acids as the cause, while 40% of respondents incorrectly linked it to dental caries. Understanding of dental erosion varied significantly by participants' education level (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Most participants recognized erosion as a serious condition (73.8%) and reported it affected general health (84.8%). However, only 30.2% were aware of available treatments, whereas 62.3% knew prevention methods.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eAlthough most parents in the sample had heard of erosion, many reported limited knowledge of available treatment options. Educational level influences knowledge and dental care behaviors. Additionally, dietary habits and inconsistent dental visits remain prevalent, underscoring the need for targeted public health education.\u003c/p\u003e","manuscriptTitle":"Parental Knowledge of Dental Erosion and Erosion-Related Risk Factors in Children in various regions of Saudi Arabia.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-04 06:13:05","doi":"10.21203/rs.3.rs-9390474/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-30T23:55:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-25T14:30:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"219263755713484934886820973307320916420","date":"2026-04-25T05:46:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283663767057562406565455840902957773488","date":"2026-04-24T17:59:25+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-22T17:42:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-18T05:18:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-18T05:18:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Umm Al-Qura University for Medical Science","date":"2026-04-11T20:37:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-umm-alqura-university-for-medical-science","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Umm Al-Qura University for Medical Science](https://link.springer.com/journal/44361)","snPcode":"44361","submissionUrl":"https://submission.springernature.com/new-submission/44361/3","title":"Journal of Umm Al-Qura University for Medical Science","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9662672f-09a4-4b92-9894-a240c166c9db","owner":[],"postedDate":"May 4th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-04-30T23:55:48+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-15T21:38:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-04 06:13:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9390474","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9390474","identity":"rs-9390474","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}