Exploring Oral Health Challenges and Barriers to Dental Care Among Children in Cabo Verde: A Qualitative Study.

Objectives: Global oral health is a crucial topic since this (largely preventable) burden affects 3.5 million people worldwide, disproportionately impacting disadvantaged groups and exacerbating in low- and middle-income countries like Cabo Verde. Our aim in this exploratory study was to understand the oral health landscape for children in Sal, Cabo Verde. Methods: Through a purposive sampling strategy and snowballing approach, we identified 38 stakeholders, including 20 schoolchildren and 8 parents. Data were collected through semi-structured interviews and focus groups. All interviews were transcribed and analyzed using an inductive thematic approach. Results: Three main themes emerged from the data: oral health knowledge and practices, dietary habits, and dental service accessibility. Key challenges included time constraints limiting comprehensive oral health education in schools; parental struggles in managing children's habits; pervasive availability of sugar-rich foods driven by affordability and social influence; provision of sweets by tourists reinforcing uncontrolled sugar intake; and limited access to professional oral health care. Community associations played a dual role, offering support but lacking structured oral health initiatives. Discussion: This study highlights systemic barriers to oral health among Cabo Verdean children and reveals unique local dynamics. Tourism-while economically beneficial-unintentionally contributes to poor oral health through sweets distribution and shifting dietary habits, a factor rarely addressed in the literature. Limited access to affordable care and underutilized community associations further exacerbate challenges. These findings call for integrated strategies that strengthen community-based programs and embed oral health considerations into tourism and education policies.