Parental and Child Perception of Esthetic Restorative Options for Anterior Caries in Primary Teeth: A Cross-Sectional Study

Background: As pediatric dentistry evolves to emphasize esthetic outcomes, understanding parental and child preferences for restorative treatments of primary anterior teeth is essential. In India, increasing awareness and media influence are shifting expectations toward tooth-colored, esthetic restorations. Aim: To evaluate and compare the esthetic perceptions and treatment-seeking behaviors of children and their parents regarding various restorative options for anterior carious lesions in primary teeth. Materials and Methods: A cross-sectional observational study was conducted among 193 children (aged 4–6 years) and their parents ( n = 579). Participants independently assessed clinical photographs depicting varying severities of anterior caries and restorative treatments using a binary rating scale. The three sections included: (1) Threshold for seeking dental care, (2) esthetic acceptability for deep caries treatment, and (3) esthetic acceptability for mild caries treatment. Data were analyzed using descriptive statistics and the Chi-square test for associations between participant type and responses. Results: Most participants reported they would only seek dental treatment after complete destruction of the tooth crown, with fathers showing the highest delay (84.5%). Zirconia crowns were the most preferred option for deep caries across all groups (children: 77.7%, mothers: 85.5%, fathers: 82.4%), while composite resin was the most accepted for mild caries (children: 83.9%, mothers: 91.7%, fathers: 90.2%). Statistically significant differences were observed in treatment-seeking behavior ( P = 0.045) and preferences for mild caries restorations ( P = 0.0068). Conclusion: There is a clear preference among Indian parents and children for esthetic restorative materials such as zirconia and composite resin for anterior primary teeth. Pediatric dentists should address both esthetic expectations and barriers to care during treatment planning.