Early childhood caries preventive practices of children with parents who are internally displaced persons, refugees, and migrants in Nigeria: a cross-sectional study

Women and children are more severely affected during humanitarian crises, and their vulnerabilities affect their oral health practices. This study aimed to assess the associations between the reported early childhood caries (ECC) preventive practices and maternal education, knowledge of dental caries prevention, and displacement-related variables. This cross-sectional study was a secondary analysis of the data of a convenience sample of 625 mother-child dyads who identified as internally displaced persons (IDPs), refugees, and migrants in five Nigerian states—Borno, Taraba, Yobe, Cross River, and Benue – in December 2024. Children had to be younger than 6 years to be included in the data. Data extracted included study independent variable (displacement status -IDPs, refugees, migrants), dependent variables (children’s daily tooth brushing frequency, fluoridated toothpaste use, and daily consumption of refined carbohydrates in between meals), and study confounders (maternal education level -no formal education, Quranic/primary, secondary, tertiary- maternal age at last birthday, and maternal dental caries prevention knowledge). No clinical dental examinations were conducted. Multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables after adjusting for confounders. Of the 625 participants, 274 (43.8%) were children of IDPs, 120 (19.2%) were children of migrants, and 231 (37.0%) were children of refugees. The age of mothers ranged from 18 to 60, with a mean (standard deviation) of 30.8 (7.8) years. Furthermore, 81 (13.0%) reported brushing with a toothbrush at least twice daily, and 195 (31.2%) reported using fluoridated toothpaste. Compared to children of refugees, children of migrants had significantly lower odds of brushing their teeth at least twice daily (AOR = 0.391; 95% CI: 0.172–0.888; p = 0.025), while children of IDPs had significantly higher odds of using fluoride toothpaste regularly (AOR = 1.909; 95% CI: 1.218–2.990; p = 0.005). In addition, children of IDPs and migrants showed non-significantly higher odds of consuming refined carbohydrates in-between-meals less than three times when compared to refugees. This study highlights the multifaceted and interconnected factors affecting reported ECC prevention practices among displaced Nigerian children. To gain a deeper understanding of these dynamics, future research should employ longitudinal and mixed-method approaches that can better inform the development of evidence-based and culturally responsive policies and programmes.