Oral Health Status in Children from the Community of Madrid, Spain: A Population-Based Cross-Sectional Investigation.

Purpose: To evaluate the oral health status of children aged 3-14 years in the Community of Madrid, Spain, between 2017 and 2020, and to identify associated protective and risk factors. Methods: A cross-sectional, descriptive, and analytical study was conducted in 39 schools. Clinical examinations followed WHO guidelines and included caries detection (ICDAS codes 4-6), enamel developmental defects (DDE), tooth wear, malocclusion, and oral hygiene indicators. Sociodemographic data and oral hygiene habits were collected via parental questionnaires. Schools were stratified by socioeconomic status (SES). Statistical analyses were performed using SPSS v29 with a 95% confidence level (p < 0.05). Results: Data from 11,646 children (mean age: 8.46 ± 1.99 years) revealed that 40.65% had caries in at least one tooth, and 9.42% had five or more affected teeth. Caries prevalence was higher among preschoolers (48.7%) than school-aged children (40.3%). Dental restorations were present in 10.5%, while only 11.7% had at least one sealant and 4.8% had all first permanent molars sealed. DDE affected 11% of children (mild: 8.1%, moderate: 2.5%, severe: 0.4%), tooth wear 4%, dental trauma 2%, and malocclusion 41.4%. Visible plaque was observed in 62.6% of participants, despite 50.5% reporting twice-daily brushing and 29.6% brushing three or more times per day. SES strongly influenced caries prevalence: 69.4% of children from low SES backgrounds had decayed teeth compared to 23.1% and 7.5% in medium and high SES groups, respectively. Logistic regression identified low SES (odds ratio (OR)=1.53, 95% CI: 1.03-2.28) as a risk factor for caries development, while absence of malocclusion (OR=0.54, 95% CI:0.32-0.93) and absence of visible plaque (OR=0.32, 95% CI: 0.20-0.51) as protective factors in preschool children. In school-aged children, low SES (OR = 3.66; 95% CI:3.21-4.18) increased the odds of caries; while toothbrushing ≥2 times/day showed a protective effect (OR range = 0.19-0.23) and absence of visible plaque (OR = 0.59; 95% CI:0.55-0.65 for absence vs presence). Conclusion: Caries remains highly prevalent among children in Madrid, particularly in socioeconomically disadvantaged groups, highlighting the urgent need for targeted preventive strategies.