Causes and Severity of Neglected Dental Caries in Rural Sri Lankan Primary School Children

Untreated dental caries is one of the most prevalent childhood morbidities worldwide, yet the clinical consequences of neglected dental caries are underreported in the literature. This study aimed to quantify and describe the clinical manifestations of untreated dental caries in children, arising from neglected oral health. Additionally, it sought to investigate the parental and health system factors associated with the neglect of dental caries in children. This cross-sectional survey was conducted among 5–7-year-old children residing in the Monaragala district of Sri Lanka. Children with dental caries (dmft > 0) were included in the analysis, with a total sample size of 284. Sociodemographic data of the children and their parents were collected using a self-administered questionnaire. Dental caries was assessed and recorded using the WHO Basic Methods, while the clinical consequences of untreated caries were evaluated using the pufa index. The mean dmft, mean pufa score, and mean pufa ratio for the study population were 4.52 ± 0.3, 1.05 ± 1.5, and 22.5% ± 2.8, respectively. Clinical consequences of untreated dental caries were observed in 47.5% of the children. Pufa scores were significantly associated with the father’s age (p = 0.01), father’s occupational category (p < 0.001), and the child’s health-seeking behavior (p < 0.001). A substantial proportion of children in the study exhibited clinical signs and symptoms of neglected dental caries, despite the availability of free healthcare services in Sri Lanka. Strengthening awareness of children’s oral health needs is strongly recommended. Furthermore, the development and implementation of preventive oral health programs targeting preschool-aged children, particularly those from socioeconomically disadvantaged populations, is imperative.