Parental Cognition Regarding Children's Sugar Consumption and Its Implications for Dental Caries Prevention: A Systematic Review.

BACKGROUND/OBJECTIVES: Parental perceptions, beliefs, attitudes, and knowledge may influence children's sugar exposure, but these cognitive constructs are distinct from children's actual intake. This review synthesised parental cognition regarding children's sugar consumption and secondarily examined its relationship with reported or measured intake and implications for caries prevention. METHODS: PubMed, Scopus, PsycINFO, CINAHL, and Web of Science were searched for primary studies published from January 2016 to April 2026. Study selection and narrative synthesis followed PRISMA 2020. RESULTS: We included 35 studies from ten countries: 19 cross-sectional, 6 qualitative, 4 experimental/randomised, 2 pre-post, 1 longitudinal, and 3 other survey-based or mixed-design studies. Misperceptions of product healthfulness and limited knowledge of sugar content were common. Associations between cognition and children's intake were inconsistent; parental modelling, household availability, cultural norms, and commercial influences were also associated with sugar exposure. Most evidence was observational, measures were heterogeneous, and no study measured dental caries directly. CONCLUSIONS: Parental cognition is relevant but insufficient on its own to explain children's sugar exposure. Caries-preventive counselling should combine factual education with attention to caregiver behaviour and the home food environment.