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Background: Permanent first molars (PFMs) are essential for children’s oral development and long-term dentition, but their early eruption and high susceptibility to caries place them at risk, particularly when parental knowledge and awareness are limited. This study aimed to investigate parental knowledge, awareness, and competence regarding permanent first molars (PFMs) and their associations with children’s clinical outcomes, parental oral health literacy, and behavioral factors. Methods: A total of 135 parent-child dyads were enrolled in this cross-sectional study.

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