The relationship between parental attitudes towards health and child development has been a topic of interest for many years; however, research results in this field are still inconsistent. This study aimed to develop a structural equation model of the Parental Attitudes toward Child Oral Health (PACOH) scale, using this model to analyse the relationship between parental attitudes with demographic variables and the oral health-related behaviour of parents and children. A total of 302 parents (87% mothers) answered questions regarding their own and their children's, aged 4-7 years, oral health-related actions and completed the 38-item PACOH scale. The structural equation model indicated that parental attitudes captured by the PACOH scale can be fitted to a second-order factorial model, even with the scale shortened to 21 items. The model demonstrated good fit characteristics (CFI = 0.925; IFI = 0.927; GFI = 0.915; RMSEA = 0.049), making it a reliable tool for examining the structure of parental attitudes. This model was employed in the multi-group analysis, revealing the close relationship between positive parents' attitudes towards their child's oral health and oral health-promoting behaviour both in parents and children, such as regular tooth brushing (p < 0.001), visiting the dentist (p = 0.027), and parents helping their child brush his/her teeth (p < 0.001). In light of these findings, it was concluded that Parental Attitudes towards Child Oral Health should be considered an essential factor influencing the development of oral health-promoting behaviour in children.
Keywords: children; oral health; parental attitudes; scales; second-order factor model; structural analysis; tooth brushing.