Untreated dental caries among Libyan children during and after the war and in internally displaced person camps

• Published in: Community dentistry and oral epidemiology 2023-08, Vol.51 (4), p.636-643
• Main Authors: Arheiam, Arheiam, Alhashani, Abdelgader, Kwidir, Tasnem, Bosif, Yasmin, Ballo, Lamis, Tantawi, Maha El
• Format: Article
• Language: English
• Subjects: behavioral science; caries; Children; Childrens health; Data collection; Dental care; Dental caries; Dentition; Displaced persons; Education; Educational attainment; Health disparities; Oral hygiene; Parent educational background; Parents & parenting; psychosocial aspects of oral health; Regression analysis; Sociodemographics; Teeth; War
• ISSN: 0301-5661; 1600-0528
• DOI: 10.1111/cdoe.12886

Objectives The present study assessed whether living in a conflict zone and in internally displaced person (IDP) camps were associated with the number of untreated caries in primary, permanent and all teeth in Libyan children and whether these associations differed by parents' educational attainment. Methods Cross‐sectional studies were conducted in Benghazi, Libya, in 2016/2017 during the war and in 2022 after the war including children in schools and in IDP camps in the same setting. Self‐administered questionnaires and clinical examinations were used for data collection from primary schoolchildren. The questionnaire collected information on children's date of birth, sex, level of parental education and school type. The children were also asked to report on how often they consumed sugary drinks and whether they brushed their teeth regularly. In addition, untreated caries in primary, permanent and all teeth were assessed according to World Health Organization criteria at the dentine level. Multilevel negative binomial regression models were used to assess the relation between dependent variables (untreated caries in primary, permanent and all teeth) and living environment (during and after the war and living in IDP camps) and parental educational attainment adjusted for oral health behaviours and demographic factors. The modifying effect of parental educational attainment (no, one and both parents university educated) on the association between living environment and the number of decayed teeth was also assessed. Results Data were available from 2406 Libyan children, 8–12 years old (mean = 10.8, SD = 1.8). The mean (SD) number of untreated decayed primary teeth was 1.20 (2.34), permanent teeth = 0.68 (1.32) and all teeth = 1.88 (2.50). Compared to children living in Benghazi during the war, children living in the city after the war had significantly greater number of decayed primary (adjusted prevalence ratio [APR] = 4.25, p = .01) and permanent teeth (APR = 3.77, p = .03) and children in IDP camps had significantly greater number of primary teeth (APR = 16.23, p = .03). Compared to children whose both parents were university‐educated, those with no university‐educated parents had a significantly greater number of decayed primary teeth (APR = 1.65, p = .02) and significantly less number of decayed permanent (APR = 0.40, p