Predictors of dental caries among inmates in the Eastern Province of Saudi Arabia: A cross-sectional study.

Abstract

Objective: Oral health is a neglected aspect of healthcare, especially among prison inmates who face barriers in accessing dental services. Dental caries is a prevalent and preventable disease that affects inmates' general health and quality of life. This study evaluated dental caries and its predictors among inmates in the Eastern Province of Saudi Arabia.

Methods: This cross-sectional study was conducted as part of an ongoing oral health program by the College of Dentistry, Imam Abdulrahman Bin Faisal University(IAU), Dammam, targeting inmates in prisons across Dammam, Khobar, Dhahran, Jubail, and AlHasa in the Eastern Province of Saudi Arabia. This prison outreach program is conducted annually from January to April. Male and female inmates who voluntarily consented were included without exclusion criteria. Data collection involved oral examinations using the DMFT index and Simplified Oral Hygiene Index (OHI-S), following World Health Organization's (WHO) criteria, and structured interviews based on the WHO Oral Health Questionnaire for Adults. Calibrated examiners performed the examinations using portable dental units. Statistical analysis included t-tests, ANOVA, Pearson correlation, and multiple linear regression analysis.

Results: The sample consisted of 230 participants with 86.1% males and 13.9% females. In the study, 98.3% of the sample had untreated decay and 99.1% of participants had DMFT score ranging from 1 to 28, with a mean score of 14.41 ± 7.89. About 25.2% of participants never cleaned their teeth using any tool, 23.5% did not use toothpaste, and 23.5% consumed soft drinks several times a day. Dental attendance, defined as being seen by a dentist at prison, within the last year was reported by 37% of participants and 15.2% never received dental care. Most participants (85.2%) reported dental pain during the last year. The study showed a statistically significant correlation between the simplified oral hygiene index and the mean decayed score (r = 0.456, P < 0.001). The mean DMFT of the sample significantly increased with advancing age (P = 0.023). Male participants (15.12 ± 7.94) demonstrated significantly higher mean DMFT score than females (10.03 ± 6.05) (P = 0.001). Similarly, significantly higher DMFT was found in Saudi (15.74 ± 7.91) versus non-Saudi participants (10.45 ± 6.41) (P < 0.001). Those who used toothpaste (12.82 ± 6.95) had significantly lower mean DMFT score than those who did not use toothpaste (19.59 ± 8.58) (P = 0.006). A statistically significant relationship was observed between soft drink consumption and caries experience (P = 0.043).

Conclusion: Untreated decay was highly prevalent among inmates in this study. A statistically significant correlation was found between oral hygiene and caries experience, with advancing age, male gender, Saudi nationality, and frequent soft drink consumption being significantly associated with higher caries levels. These findings highlight the urgent need for targeted oral health promotion strategies and improved access to dental care within correctional facilities. Policy implications include the integration of oral health education into prison health programs and the establishment of routine dental screenings. Future research should explore the effectiveness of mobile dental services and behavioral interventions tailored to this high-risk population.