Dental Caries and Oral Health Practices in Children of High-Income Families from Central Areas in Non-Fluoridated Istanbul, Türkiye

Abstract

OBJECTIVES: This study aimed to determine the prevalence of dental caries and assess oral health practices among children from affluent families in central Istanbul without community water fluoridation. The associations between parental education and fluoride supplementation with caries occurrence were also assessed. METHODS: A cross-sectional study was conducted with 350 children aged 6–11 years enrolled in a private school representative of high socioeconomic status in Istanbul. Oral examinations followed WHO criteria and were performed by two calibrated examiners (Kappa>0.7). Questionnaires regarding fluoride exposure, toothbrushing frequency, dental visits, and parental education were completed by 250 parents (71.4% response rate). Data analysis included chi-square and independent samples t-tests (p<0.05). RESULTS: Dental caries prevalence was 75.1%; only 24.9% of children were caries-free. Mean dft and dfs scores were 2.37 ± 2.47 and 3.97 ± 4.93; DMFT and DMFS scores were 1.54 ± 1.79 and 2.03 ± 2.71, respectively. The mean total caries experience was 3.91 (95% CI: 3.58–4.24). Fluoride supplementation was reported by 24.4% of parents until age 3, 4.4% until age 6, and 57.6% never supplemented; no significant link was found between supplementation and caries (p>0.05). Regular toothbrushing (≥2 times/day), routine dental visits, and higher maternal education significantly correlated with lower caries prevalence (p<0.05). Parental supervision and age at brushing initiation were not significantly associated with caries occurrence (p>0.05). CONCLUSIONS: Dental caries remain highly prevalent in central Istanbul despite high socioeconomic status. Preventive strategies emphasizing maternal education and consistent oral hygiene behaviors may yield greater improvements than fluoride supplementation alone.

Keywords

• dental caries
• fluoride
• oral hygiene
• maternal education
• socioeconomic status
• children

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