Ultra-Processed Food Consumption Among Caregivers and Children in the “Happy Smile” Project: Associations with Family Dietary Patterns and Periodontal Health-Related Quality of Life

<b>Background/Objectives:</b> The consumption of ultra-processed foods (UPFs) has increased markedly in recent decades and has been associated with adverse health outcomes. In childhood, the family environment plays a central role in shaping dietary habits and oral health behaviors. This study investigated the association between UPF consumption by caregivers and children, its relationship with caregivers' periodontal health-related quality of life, and described children's dietary practices and oral hygiene habits. <b>Methods:</b> This cross-sectional study was conducted with caregivers of children participating in the Happy Smile Project in Birigui, São Paulo, Brazil. UPF consumption was assessed using a questionnaire based on the NOVA classification, and periodontal health-related quality of life was evaluated using the OHIP-14-PD. <b>Results:</b> A high frequency of UPF consumption was observed among both caregivers and children. Children whose caregivers had high UPF consumption were more likely to also present high consumption (OR = 9.96; 95% CI: 5.38-18.44; <i>p</i> < 0.001). Higher caregiver education was associated with lower odds of high UPF consumption among children. Children in the high-consumption group were older and showed higher consumption of sweetened milk beverages (<i>p</i> < 0.001). Risk behaviors for oral health, such as nighttime use of sweetened bottles and absence of toothbrushing afterward, were frequently reported. Regarding periodontal health-related quality of life, only the physical disability domain showed significantly higher scores among caregivers with high UPF consumption (<i>p</i> = 0.014). <b>Conclusions:</b> This study demonstrated that high consumption of ultra-processed foods by caregivers significantly increased the odds of children's consumption and was associated with a greater negative impact on caregivers' periodontal health-related quality of life, specifically in the physical disability domain. In addition, children exhibited a high frequency of oral health-damaging behaviors. These findings highlight the importance of family-centered strategies aimed at reducing the intake of ultra-processed foods and promoting healthier dietary and oral health behaviors.