Determinants of Dental Caries among Rural Primary School Children in Romania: The Role of Oral Health Education, Prevention, and Access to Care

Abstract

Background: Dental caries remains one of the most prevalent chronic diseases in childhood and represents a significant public health challenge, particularly in rural communities where preventive measures and access to dental care are limited.

Objective: To assess oral hygiene practices, dietary habits, access to dental services, and parental attitudes toward prevention among primary school children from a rural Romanian community, and to identify factors associated with increased caries risk.

Materials and Methods: A cross-sectional study was conducted in Mileanca, Botoșani County, Romania. The study included 60 children aged 6–10 years and their parents. Data were collected using structured questionnaires addressing oral hygiene behaviors, dietary habits, dental attendance, and parental perceptions of oral health prevention. Clinical observations were performed to identify visible carious lesions and dental calculus. Following data collection, an educational intervention focusing on toothbrushing techniques, fluoride use, healthy nutrition, and preventive strategies was delivered.

Results: Only 30.0% of children reported brushing their teeth twice daily, while 18.3% brushed rarely or not at all. Fluoridated toothpaste was used by 28.3% of participants, whereas 56.7% reported using non-fluoridated toothpaste. Frequent daily consumption of sugary foods was reported by 48.3% of children, and 20.0% consumed sweetened beverages daily. More than half of the participants (53.3%) had never visited a dentist. Additionally, 95.0% of parents reported the absence of a dental office within the community. Clinical observations confirmed the presence of visible dental caries and calculus deposits in a substantial proportion of children.

Conclusions: Rural children face multiple preventable risk factors for dental caries, including inadequate oral hygiene, high sugar consumption, limited fluoride exposure, and restricted access to dental services. Community-based oral health education programs and improved availability of preventive dental care may contribute substantially to reducing oral health inequalities and the burden of dental caries in underserved rural populations.