Parental knowledge, attitude, and practice on oral complications of leukemia treatment: a cross-sectional study

Abstract

Leukemia is among the most common childhood cancers, and treatments such as chemotherapy and radiotherapy often lead to oral and dental complications. With rising survival rates, attention to oral health and its impact on quality of life has become increasingly important. Parental knowledge and practice play a vital role in preventing and managing these complications. Therefore, this study assessed the knowledge, attitude, and practice (KAP) of parents of children with leukemia regarding oral symptoms and complications during 2024–2025. This cross-sectional study was conducted at Seyed-al-Shohada Hospital in Isfahan, Iran. A non-random convenience sample of 80 parents of children aged 1–18 years undergoing treatment in pediatric oncology and hematology wards was selected. Data were collected using a researcher-developed questionnaire covering demographics and KAP domains. Analysis was performed using SPSS version 26, with Chi-Square tests for associations. Of the 80 participants (73.8% female), most were aged 20–40 years and had completed education up to the high school level or less. Among all children, 71.3% were diagnosed with acute lymphoblastic leukemia (ALL). Only 17.5% of parents demonstrated good knowledge, 53.8% had a positive attitude, and 8.8% showed adequate oral care practices. Parental education level was significantly associated with knowledge ( p  = 0.021), while other demographic variables showed no significant associations. Oral complications were reported in 48.8% of children, and limiting high-risk behaviors correlated with better practice scores. Recognition of early leukemia symptoms varied widely among respondents, with no statistically significant pattern observed. Only 13% ( n  = 10) of parents reported seeking dental care for pain or abscess. Parents generally lacked sufficient knowledge and caregiving practice regarding oral care in children with leukemia, despite a relatively positive attitude. Parental education level was associated with awareness, highlighting the importance of formal education in improving oral health literacy. Although general supportive measures such as dietary adjustments and increased rest were commonly reported, they were less effective than targeted behavioral strategies in improving oral care outcomes. These findings suggest the need for structured educational programs to enhance parental caregiving and oral health outcomes in children with leukemia. However, larger multicenter studies are needed to confirm these findings and evaluate the effectiveness of such interventions.