Caries experience and associated factors among Iranian and Afghan immigrant adolescents aged 13–15 years in Tehran: a cross-sectional study

BACKGROUND: Dental caries can be significantly associated with many sociodemographic and behavioral factors. The present study aimed to evaluate and compare caries experience and associated determinants among Iranian and Afghan adolescents in Tehran in 2024. METHODS: This cross-sectional study conducted on 761 students aged 13 to 15 years old who were selected through multistage random sampling from 18 secondary schools. Data on sociodemographic characteristics and oral health behaviors were collected via a self-reported questionnaire. Decayed, missing, and filled teeth (DMFT), and dental plaque were measured through a clinical examination form. Both univariate and multivariate logistic regression models were applied to examine the associations of sociodemographic, behavioral, and clinical factors with caries experience. All statistical analyses were done using SPSS Version 26. RESULTS: Of total students, 46.6% were Afghan. Dental caries prevalence was approximately 72.5% in both nationalities. Being Iranian male was associated with a decrease of dental caries (OR = 0.54; 95% CI = 0.33-0.90, p = 0.02). The more the Iranian adolescents reported dental flossing the more caries experience they had (OR = 1.89; 95% CI = 1.04-3.43, p = 0.04). Negative association was found between mother education and caries experience among Afghan school children (OR = 0.28; 95% CI = 0.09-0.91, p = 0.04). Lower family size was associated with a decrease of dental caries among Afghan students (OR = 0.56; 95% CI = 0.32-0.98, p = 0.04). Having dental plaque was positively associated with caries experience among Iranian (OR = 1.96; 95% CI = 1.13-3.39, p = 0.02) and Afghan adolescents (OR = 1.60; 95% CI = 1.05-2.30, p = 0.03). CONCLUSIONS: Both Iranian and Afghan immigrant students experienced high dental caries. Policies should be prioritized on culturally tailored school-based flossing and plaque control programs, maternal oral health literacy interventions, and family-size-sensitive service delivery. Immediate action under the World Health Organization(WHO) agenda for universal oral health coverage is warranted to reduce the prevalence of dental caries among immigrant adolescents.