A Comparative Study of Oral Health and Behavior Among 7-9-Year-Old Iranian and Afghan Children : Oral Health and Behavior Among 7-9-Year-Old Iranian and Afghan Children.

Background: Afghan immigrants represent the largest foreign-born population residing in Iran. the present study aimed to perform a comparative evaluation of the dmft index and oral health behaviors among Iranian and Afghan children aged 7 to 9 years residing in Pishva County. Materials and Methods: In this 2023 cross-sectional study, 157 children (87 Iranian and 70 Afghan) were recruited via convenience sampling. Participants were selected from elementary schools in Pishva County, Iran. Oral health behaviors were evaluated using the culturally adapted Oral Health Behavior Self-Reporting Questionnaire Parents completed these self-administered questionnaires designed to capture information on their children's oral health behavior, source of information and school grade level. Statistical analyses were performed using SPSS 21 statistical software through Chi-square, Shapiro-Wilk test, General Linear Model (GLM), Mann Whitney U and Fisher's exact tests. Results: A comparison of dmft categories revealed that Iranian children had a lower prevalence of severe dental caries: 32% were classified as "High" and 3% as "Very High," whereas 39% of Afghan children were classified as "High" and 27% as "Very High" (P0.001). Oral Health Behavior scores were significantly higher in the Iranian cohort (mean ± SD: 6.70 ± 1.37) compared to the Afghan cohort (mean ± SD: 4.50 ± 1.43; P 0.001). In the GLM predicting the dmft index, ethnicity emerged as a significant independent predictor (Wald χ²₁ = 70.806, P = 0.005). Additionally, the three-way interaction among ethnicity, school grade level, and oral health behavior was highly significant (Wald χ²₅ = 22.472, P 0.001). However, the main effects of school grade level and oral health behavior, when considered independently, did not reach statistical significance. It was observed that younger children had higher dmft scores, suggesting that age is a contributing factor in the prevalence of dental caries. No statistically significant difference was observed between the groups in terms of gender (P = 0.078). However, a significant difference was found in school grade level between the two groups (P = 0.018), as indicated by the chi-square test. Conclusion: The findings indicate that Iranian children aged 7-9 years generally demonstrate better oral health status and more favorable oral hygiene behaviors compared to Afghan immigrant children. Afghan children had both lower levels of oral health performance compared to Iranian children. These observed disparities underscore the influence of migration-related determinants on pediatric oral health, highlighting the necessity for culturally sensitive public health interventions targeting immigrant populations.