Determinants of Caregiver-reported Dental Caries among Preschool Children in Selected Communities in Okrika Local Government Area, Rivers State, Nigeria

Background: Caregiver reports are often used to identify possible oral health problems in young children, but their correspondence with clinically assessed dental caries may vary across settings. Aims: This study examined the prevalence and determinants of caregiver-reported caries indicators and clinically assessed caries among preschool children in Okrika Local Government Area, Rivers State, Nigeria. Study Design: Community-based analytical cross-sectional study. Place and Duration of Study: Five communities (Ibaka, Ogbogbo, Ogoloma, Kalio and Okochiri) in Okrika Local Government Area, Rivers State, Nigeria, [2nd May 2026 to 28th June 2026]. Methodology: The study included 389 caregiver–child pairs selected by multistage sampling. Caregivers completed a structured questionnaire, and children aged 3–5 years had a clinical oral examination using the decayed, missing and filled primary teeth (dmft) index. Caregiver-reported caries was defined as an affirmative response to at least half of ten caries-related items. Data were analysed using chi-square tests, Cohen’s kappa and binary logistic regression. Results: By the composite measure, 269 children (69.2%) were classified as caregiver-reported caries positive, whereas clinical examination identified caries in 20 children (5.1%; mean dmft = 0.06). Agreement between the two measures was no better than chance (κ = −0.006; χ² = 0.17, P = .68). Against clinical status, caregiver report had a sensitivity of 65.0% and a specificity of 30.6%. An unfavourable environment was associated with caregiver-reported caries (adjusted odds ratio [AOR] = 2.81; 95% CI: 1.64–4.81; P < .001), whereas poor caregiver knowledge did not reach statistical significance (AOR = 1.85; 95% CI: 0.997–3.44; P = .051). No factor was associated with clinical caries, but only 20 children were affected, so these estimates are imprecise. Conclusion: Caregiver-reported indicators reflect perceived dental problems rather than clinical caries and should complement, not replace, clinical examination. Routine preschool dental screening and caregiver education are recommended.