Oral health status and socio-behavioral predictors among the Lodha tribe in Odisha, India: a community-based cross-sectional study

Background Socio-historical marginalization drives health disparities among the Lodha tribe, a Particularly Vulnerable Tribal Group (PVTG) in Odisha. The lack of baseline oral health epidemiological data limits targeted health planning. This study aimed to determine oral disease prevalence, oral hygiene status, and socio-behavioral determinants of treatment urgency among the Lodha PVTG in Mayurbhanj, Odisha. Methods A community-based cross-sectional survey ( N = 346 adults) was conducted across four administrative blocks in the Mayurbhanj District using a multi-stage cluster sampling design. Data were collected using modified WHO questionnaires and Type III clinical examinations. Clinical metrics included the Decayed, Missing, and Filled Teeth (DMFT) index, Simplified Oral Hygiene Index (OHI-S), and Community Periodontal Index (CPI). Multivariate binary logistic regression used to identify independent predictors of prompt/immediate treatment urgency. Results Participants had a mean OHI-S score of 3.42 ± 1.12, with 61.3% presenting poor oral hygiene. Untreated decay almost entirely drove the mean DMFT of 0.68 ± 1.42 (DT = 0.61 ± 1.31; FT = 0.003 ± 0.05). Periodontal disease was observed in 62.7% ( n = 217) of participants, with 40.5% demonstrating moderate (4–5 mm) pockets and 22.2% demonstrating severe (≥6 mm) pockets. Oral mucosal lesions affected 33.5% of the sample, with oral leukoplakia dominating cases (9.0%). Dental service utilization remained low, as 89.6% had never visited a dentist. Logistic regression identified tobacco use (aOR = 3.42, 95% CI: 2.11–5.54, p < 0.001), poor self-perceived health (aOR = 2.15, 95% CI: 1.28–3.61, p = 0.004), and age ≥65 years (aOR = 1.87, 95% CI: 1.05–3.33, p = 0.03) as independent predictors of treatment urgency. Conclusion The Lodha PVTG exhibits a high burden of untreated periodontal disease and oral precancerous lesions alongside minimal dental service utilization. Targeted oral healthcare services and tobacco cessation programs should be included in tribal development micro-projects to address these disparities.