WHO 2013-Based assessment of oral health status and intervention urgency among dental outpatients at a provincial tertiary care hospital in lumbini province, Nepal

Oral diseases are a major public health problem, particularly in low- and middle-income countries, yet reliable clinical data remain scarce in countries like Nepal. No standardised clinical assessment of oral health status and treatment needs has previously been reported from a provincial hospital setting in Lumbini Province. This study assessed oral health status and intervention urgency among dental outpatients at a provincial tertiary care hospital using the World Health Organization (WHO) Oral Health Assessment Form for Adults, 2013. A hospital-based cross-sectional study was conducted in the Department of Dental Surgery, Lumbini Provincial Hospital, Butwal, from July to November 2025. Using systematic sampling, 400 patients in the WHO index age groups (15–19, 35–44 and 65–74 years) underwent clinical oral examination by three trained examiners. Dentition status, periodontal status using the modified Community Periodontal Index, loss of attachment, prosthetic status, mucosal findings, and intervention urgency were recorded. Caries experience was summarised using a derived DMFT index. Data were analysed descriptively in SPSS. Participants had a mean DMFT of 3.99 ± 4.61, rising from 2.98 ± 3.08 at 15–19 years to 8.28 ± 6.74 at 65–74 years. Overall, 331 (82.8%) had caries experience (DMFT > 0) and 291 (72.8%) had untreated or recurrent coronal decay; the decayed component (mean 2.52 ± 3.17) dominated the index, while the filled component was minimal (0.26 ± 0.79). Gingival bleeding was present in 349 (87.3%) participants and periodontal pocketing in 88 (22.0%), with severe pocketing (≥ 6 mm) in only 6 (1.5%). Tooth loss, root exposure, root caries and loss of attachment all increased steeply with age. Only 25 participants (6.3%) used a denture. On intervention urgency, 342 (85.5%) required prompt treatment or a higher level of care, and 106 (26.5%) required immediate urgent treatment for pain or infection, this proportion being highest among those aged 65–74 years (43.4%). Rural residents showed the highest mean DMFT (5.25 ± 5.77) and the highest prevalence of untreated decay (84.5%). Dental outpatients at this hospital carried a high burden of oral disease that was largely active and untreated, with disease worsening markedly with age and almost no history of restorative care. These findings show a high burden of active and untreated oral disease among dental outpatients and support strengthening prevention, early detection, and basic restorative care. Further studies are needed to assess financial, geographic, and other barriers to timely dental care.