Oral Health Status and Associated Factors in a Stratified Cluster Sample of Marginalized Palestinian Schools: A Cross-sectional Study
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Purpose:To assess factors related to the prevalence of dental caries among adolescent schoolchildren attendingmarginalised schools in the West Bank area of Palestine.Materialsand Methods: A cross-sectional study was conducted in schools participating in the School Support Pro-gram (SSP). Fifty schools identified as marginalised by the SSP were stratified by district, student gender and gradelevel to select a random sample of 20 schools. Students in the 6th and 9th grades were screened by senior dentalstudents to collect data about their weight, height, gingivalhealth and caries experience. In addition, a structuredin-person questionnaire was used to collect data about students’ oralhygiene practices, dietary habits, mother’seducation and father’s employment. Results:In total, 1282 students completed interviews and clinical screenings. The mean number of Decayed, Miss-ing and Filled Teeth (DMFT) was 6.4±4.4. Sixty-four percent had moderate gingivitis and 73% had fair oral hygiene. ‘Recent visit to the dentist’ was associated with mother’s level of education (X2=22.06, p<0.001) and father’semployment (X2=24.02, p<0.001). The final regression model showed that grade (β=0.31, p<0.001), gender (β=0.06, p<0.03), recent visit to the dentist (β=−0.06, p<0.03) and drinking fresh juices (β=−0.05, p<0.05) were statistically significant in explaining the high level of caries in this sample.Conclusions: This study indicates that Palestinian adolescents in marginalised governmental schools suffer the highest burden of dental disease and are disproportionally impacted when compared to other same-age studentsin the region. A high burden of disease was directly associated with unfavourable dietary habits, poor oral hygiene practices and challenges to accessing dental care services, and was indirectly associated with father’s employ-yymentand mother’s level of education.