Abstract: PURPOSE: To investigate the cognition, behavior and influencing factors of parents for children malocclusion and early orthodontic treatment, and to provide a reference for clinical education and public health policy development. METHODS: An on-line questionnaire was designed to collect information on the demographic characteristics, oral health care behaviors, perceptions of malocclusion and treatment attitudes of 429 parents of children aged 0-12 years. The collected data were subjected to descriptive statistics using SPSS 27.0 software package. Multiple logistic regression analysis was employed to analyze the relevant factors influencing parental perceptions. Results: Among the surveyed parents, 91.4% paid attention to children's maxillofacial development, with the main concerns being dental irregularity (39.9%) and bad oral habits (22.8%). Parents had the most sufficient awareness of "mouth breathing" (mean value: 2.46) and relatively weak awareness of "tongue-thrusting habit" (mean value: 2.18). 76.7% of parents supported early medical consultation and intervention for malocclusion, and 48.8% believed that "the earlier the correction, the better". Fifty-six percent of parents self-assessed that they had a sufficient understanding of early orthodontic treatment, and their main information sources were doctor education (72.8%) and online media (54%). Multivariate logistic regression analysis showed that regular oral examinations (OR=3.321) and parents' own history of malocclusion (OR=1.798) could significantly improve their cognitive level (P<0.001), while educational background and income had no statistically significant impact on their cognition. CONCLUSIONS: Parents in Hangzhou city have a high overall awareness of malocclusion and early orthodontic treatment, but there are limitations such as excessive attention to aesthetics, neglect of functional problems, and insufficient understanding of the intervention. It is recommended to strengthen doctor-led education and use online media resources for professional publicity.

Key words: Malocclusion, Parents, Cognitive investigation, Early orthodontic treatment