INTRODUCTION: Malocclusion is a global health problem and when not treated in childhood, can persist throughout one's lifetime. OBJECTIVE: As children are dependent on their parents/caregivers for health care, the aim of the present study was to investigate the association between parental oral health literacy and orthodontic treatment need in schoolchildren. METHODS: A descriptive, analytical, cross-sectional study with a representative sample of children eight to ten years of age was conducted. Sociodemographic questionnaire, the Sleep Disturbance Scale for Children and the Oral Health Literacy - Adult Questionnaire were sent for parents/caregivers. Children answered the Revised Children's Manifest Anxiety Scale. For the diagnosis of orthodontic treatment need, the Dental Aesthetic Index was used. Data analysis included multinomial logistic regression analyses (OR) (p < 0.05). RESULTS: Treatment need was identified for 55.2% of participants. Children with anxiety were 53% more likely to have mandatory treatment needs (OR = 1.53; 95% CI: 1.16-2.57; p = 0.04), children with sleep disturbances were 1.94 times more likely to have mandatory treatment needs (OR = 1.94; 95% CI: 1.29-2.91; p = 0.01). Children whose parents/caregivers had an insufficient level of oral health literacy were 77% more likely to have mandatory treatment needs (OR = 1.77; 95% CI: 1.04-2.99; p = 0.03). CONCLUSIONS: Orthodontic treatment need was greater among schoolchildren from families with a lower income, who lived in homes with more than five residents, whose mothers were younger, whose parents/caregivers had an insufficient level of oral health literacy, and those with sleep disorders and with anxiety.
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