Oral Health Status Among Children and Adolescents from Vulnerable Populations: A Cross-Sectional Study in Seville, Spain

TL;DR

This study found that children and teens from vulnerable backgrounds in Seville have high rates of tooth decay and poor dental care, linked to social and behavioral factors.

Contribution

The study provides new insights into oral health disparities among vulnerable populations in Seville, Spain, and identifies key behavioral and socioeconomic risk factors.

Findings

Caries prevalence was high in all age groups, especially in primary dentition with mean dft = 3.05 and DMFT = 2.99.

Low parental education, migrant background, and poor oral hygiene practices were strongly associated with worse oral health outcomes.

Multivariate analyses confirmed a strong link between social inequalities and increased dental disease burden.

Abstract

Background/Objectives: The aim of this study was to evaluate the oral health status of socially vulnerable children and adolescents in Seville and to examine its associations with behavioral and sociodemographic determinants. We hypothesized that greater social vulnerability and suboptimal behaviors would be associated with higher caries experience. Methods: A cross-sectional analytical study was conducted on 250 participants aged 2 to 17 years attending the Luis Séiquer Social Dentistry Foundation between January and March 2025. Clinical examinations followed the WHO Oral Health Surveys: Basic Methods (5th edition, 2013) and were performed by a calibrated dentist. Variables included dental caries indices (dft, DMFT), pulpal treatment needs, and oral hygiene practices. Statistical analyses included Kruskal–Wallis, Mann–Whitney U, Fisher’s exact tests, and multivariate regression models (significance level p < 0.05). Results: Caries prevalence was high across all age groups, particularly in primary dentition (mean dft = 3.05 ± 3.80; DMFT = 2.99 ± 3.66; p < 0.001). Pulp therapy needs were significantly higher among preschoolers (mean = 2.22 ± 2.31). Factors such as low parental education, migrant background, insufficient toothbrushing frequency, and frequent sugar intake were strongly associated with poorer oral health outcomes. Although fluoridated toothpaste use was widespread (>94%), dental floss use remained limited (34.8%). Multivariate analyses confirmed a strong association between social inequalities and oral disease burden. Conclusions: Children and adolescents from vulnerable groups in Seville experience a high prevalence of dental caries and substantial unmet treatment needs. Findings highlight marked oral health disparities linked to socioeconomic status, emphasizing the urgent need for early preventive programs, culturally adapted oral health education, and equitable access to dental care.

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