Heilmann, AnjaAlharbi, Khawlah2026-02-122025https://hdl.handle.net/20.500.14154/78163Background:Childhood dental caries remains widespread in high-income countries, driven by frequent exposure to free sugars and uneven preventive routines. Parents’ day-to- day decisions occur within family, service, and commercial environments that can enable or undermine healthy practices. This review synthesises qualitative evidence on how parents perceive caries and sugar, and how those perceptions translate into behaviours shaping children’s oral health outcomes. Aim:To synthesise qualitative evidence from high-income countries on how parents perceive childhood dental caries and sugar consumption, and how these perceptions shape everyday practices. Methods:A narrative review of qualitative and mixed-methods studies was undertaken (searches August 2025) across Ovid Medline, CINAHL, and Dentistry & Oral Science Source, using PCC eligibility criteria (Population–Concept–Context) and predefined inclusion/exclusion rules. Data were extracted into a structured table and synthesised narratively. Results:Twenty-five studies from seven high-income settings (Australia n=11; USA n=7; UK n=3; Netherlands n=2; Belgium, Canada, France, Qatar n=1 each) were included. Most used interviews and/or focus groups with thematic or related analyses. Across studies, parents strongly valued children’s oral health but struggled to maintain twice-daily supervised brushing and consistent sugar limits amid time pressure, fatigue, mixed advice, and service barriers (costs, eligibility/navigation, limited paediatric capacity, rigid hours). Decisions were negotiated within families-partners and grandparents often loosening rules-and were shaped by food environments that normalised frequent sugary snacks/drinks and confusing labelling. Knowledge gaps were common; when to start brushing, fluoride use, first-visit timing; interpretation of “no added sugar”. These patterns map onto high motivation, uneven capability, and constrained opportunity, suggesting information alone is insufficient to shift behaviour. Conclusions: Improving children’s oral health requires aligning clear, consistent guidance with practical, family-centred supports and easier access to prevention. Priority actions include establishing early dental homes linked to maternity/early-years contacts, navigation help and flexible child-friendly appointments, and settings-based programmes in nurseries/schools-alongside upstream measures that curb the availability, promotion, and routine presence of high-sugar products64enChildhood dental cariesParental perceptionsSugar consumptionThesis