Exploring oral health knowledge, attitudes and practices and oral health care utilization among Nepalese migrant population

Objectives: Nepalese bear a high burden of oral diseases yet underutilize dental services, but these issues remain unexplored among the Nepalese diaspora in Canada. This thesis comprised a scoping review mapping oral health knowledge, attitudes, practices, and behaviors (KAPB) among Nepalese globally, and a survey examining oral health service utilization (OHU) and associated factors among Nepalese migrants in British Columbia (BC), Canada. Methods: The review followed Joanna Briggs Institute methodology and PRISMA-ScR reporting. Literature until November 12, 2025, was searched across databases including MEDLINE, Scopus, Web of Science, and grey literature sources, with independent dual screening. Data from agreed upon literature were tabulated using a comprehensive extraction table. For the survey, an anonymous online questionnaire (Qualtrics®) was distributed among Nepalese migrants in BC (October–December 2025), recruited through community-based approaches. The outcome for the survey was having a dental visit since immigrating. Bivariate analyses were followed by multivariate logistic regressions guided by Andersen's Behavioral Model, with significant variables entered a final hierarchical model (IBM SPSS Statistics version 31.0). Results: Forty-two studies (2004–2025) were included; none focused on Nepalese migrants. Knowledge and attitudes were generally positive, however preventive behaviors such as flossing and routine dental visits were uncommon. The survey sample (N = 368) was predominantly young, educated, and newcomers. Overall, 62% had never visited a dental professional, visits were largely reactive, and the most reported barrier was financial. Temporary residency (OR = 0.22, 95% CI: 0.08–0.60), and lack of dental insurance (OR = 0.12, 95% CI: 0.06–0.26) predicted lower utilization, while oral health problems (OR = 2.44, 95% CI: 1.17–5.08), consulting a dental professional during oral problems (OR = 3.26, 95% CI: 1.47–7.24), and regular flossing (OR = 2.54, 95% CI: 1.20, 5.26) predicted higher utilization. KAPB variables explained an additional 6.5% of variance beyond structural factors. Conclusion: Evidence on oral health KAPB among Nepalese lacks migrant-focused research. Among Nepalese migrants in BC, OHU was low and reactive, driven by immigration status, duration of stay, and dental insurance, with KAPB factors contributing independently, indicating the need for structural interventions and targeted oral health promotion.