Comparative Analysis of Caries Prevalence in Urban and Rural Pediatric Populations

Thesis Abstract

Oral health disparities between urban and rural pediatric populations remain a significant public health concern, with recent observations suggesting higher prevalence and severity of dental caries among children residing in rural areas due to limited access to preventive services, inadequate oral health awareness, and socioeconomic factors. This study aims to conduct a comprehensive comparative analysis of dental caries prevalence in urban versus rural pediatric populations, focusing on identifying underlying determinants and informing targeted intervention strategies. The specific objectives include quantifying the prevalence of dental caries in both settings, examining associated demographic, behavioral, and socioeconomic factors, and evaluating the contribution of oral health knowledge and access to care to disparities observed. Employing a cross-sectional descriptive survey design, the study targets children aged 6–12 years attending primary healthcare centers in a metropolitan city with diverse urban and rural catchment areas. A stratified random sampling technique selected a total sample of 600 children, with 300 participants from urban clinics and 300 from rural clinics, ensuring proportional representation across age, gender, and socioeconomic status. Data collection involved structured clinical examinations conducted by calibrated dentists utilizing the Decayed, Missing, and Filled Teeth (DMFT) index based on WHO oral health assessment protocols, alongside a self-administered structured questionnaire capturing demographic data, oral health practices, dietary habits, socioeconomic status (evaluated using a simplified version of the Poverty Line Indicator), and oral health knowledge levels. Data analysis employed descriptive statistics to outline prevalence rates and demographic distributions, while inferential statistics included chi-square tests to examine associations between categorical variables, independent t-tests to compare mean DMFT scores between groups, and multivariate logistic regression models to identify significant predictors of caries prevalence. To explore potential mediating effects of oral health knowledge and access, structural equation modeling (SEM) was applied, allowing for an integrated analysis of direct and indirect relationships. The anticipated findings suggest a significantly higher prevalence of dental caries in the rural pediatric population (expected mean DMFT score of 3.2 ± 1.8) compared to their urban counterparts (expected mean DMFT score of 2.1 ± 1.4). It is also hypothesized that poor oral health knowledge, low socioeconomic status, and limited access to dental care services will be strongly associated with increased caries prevalence in rural children. The regression and SEM analyses are expected to reveal that socioeconomic factors and oral health literacy serve as mediators in the relationship between geographical residence and caries experience. This research is poised to contribute novel insights into the complex multifactorial determinants underpinning oral health disparities, particularly elucidating how access and knowledge influence caries prevalence across contrasting geographical settings. Its findings are intended to inform policymakers and healthcare practitioners about critical areas for targeted interventions, including community-based oral health education, improved service delivery models in rural regions, and socioeconomic support mechanisms tailored to vulnerable populations. The study concludes that addressing disparities in dental caries prevalence necessitates multidimensional strategies emphasizing health literacy improvement and equitable access to preventive and restorative oral health services. Recommendations include the integration of oral health education into school curricula, expansion of community-based dental outreach programs in rural areas, and policymaker advocacy for resource allocation aligned with identified risk factors. Future research should explore longitudinal designs to assess the impact of targeted interventions over time and incorporate qualitative approaches to gain deeper insights into cultural and behavioral barriers affecting oral health behaviors among children in disparate settings.