Work

Caries burden and oral hygiene behaviour among attendees at humanitarian dental clinics in Ukraine: a two-wave repeated cross-sectional study

Year: 2026

Type: article

Abstract: Contemporary oral health data from conflict-affected Ukraine are scarce. We described the caries burden and its behavioural correlates among attendees at two humanitarian dental mission waves (April 2025, April 2026) at geographically exposed Korosten and rear-area Ternopil. Two-wave repeated cross-sectional study in a convenience sample of civilians attending free MacKay Memorial Hospital mobile dental clinics; participants were recruited afresh at each wave and not followed longitudinally. One calibrated dentist examined everyone at both sites in both waves, recording dentition status by WHO criteria, from which DMFT (decayed, missing and filled permanent teeth) was derived. A back-translated questionnaire was administered by interpreters immediately before examination. The primary outcome was total DMFT, modelled by negative-binomial regression with cluster-robust standard errors, adjusting for wave, location, sex, age (restricted cubic spline, four knots) and three oral hygiene behaviours. Secondary outcomes were any untreated decay, high caries burden (DMFT ≥ 14) and care indices. Holm correction across nine pre-specified tests was the primary criterion for confirmatory claims. Of 112 eligible attendees (age 5–81 years; 52.7% male), 111 contributed permanent-dentition data; 93.7% had caries experience. Mean DMFT was 10.75 (SD 7.09), the missing component predominating (4.93). Korosten attendance was associated with a higher burden (adjusted incidence rate ratio 1.26, 95% CI 1.02–1.55, p = 0.036), or 2.47 more affected teeth per attendee (0.13–4.82). The contrast was concentrated in untreated decay (component IRR 2.38, 1.38–4.13) and in caries experience: no Korosten attendee was caries-free, against 10.4% at Ternopil. Twice-daily brushing was associated with a lower burden (0.75, 0.61–0.91, p = 0.004). Mission wave was not independently associated with DMFT (0.84, 0.64–1.10). The brushing association survived Holm correction (adjusted p = 0.033); the location association did not (0.226). Attendees at humanitarian dental clinics in war-affected Ukraine carried a heavy caries burden dominated by missing teeth. Attendance at the exposed site was associated with more untreated decay, and twice-daily brushing with a lower DMFT. Both are associations in a small, self-selected convenience sample examined once; neither supports a causal interpretation, and the estimates describe clinic attendees rather than population prevalence.

Source: BMC Oral Health

DOI: 10.1186/s12903-026-10397-0