Dental Caries of Newly Arrived Refugee Children Compared with US Children

Objectives: To describe caries experience and untreated caries among newly arrived refugee children and compare to children living in the United States. Methods: A dental hygienist conducted oral health assessments of refugee children within one month of arrival in the U.S from 1/01- 9/02. Demographic and behavioral information for these refugee children were also obtained. Comparisons of caries experience and untreated caries were made between refugee children and similarly aged children in the U. S. (NHANES III). Initial comparisons were performed using chi-squared tests of independence. Further comparison of untreated caries was conducted using a multiple logistic regression model with adjustment for age, race/ethnicity, and prior dental treatment. Results: 224 refugees between the ages of 6 months and 18 years (mean: 10.5 years), were screened for oral disease. Africans comprised 53.6% (120/224) of refugee children while Eastern Europeans accounted for 26.8% (60/224). 51.3% (115/224) of refugee children had caries experience, and 48.7% (109/224) of refugee children had untreated caries. U.S.-resident children had similar caries experience (49.3%; 5572/11297; p=0.60) compared to refugee children. However, significantly fewer U.S.-resident children had untreated caries (22.8%; 2572/11296) compared to refugee children (p<0.001). Further investigation of untreated caries using multiple logistic regression showed white refugee children had 3.9 times the risk of untreated caries compared to white U.S.-resident children (p<0.01). However, black refugee children were similar to black U.S.-resident children in untreated caries risk (OR=0.94; p=0.80). Conclusions: Unmet dental needs are highly prevalent among refugees, particularly white refugees. However, the risk of untreated caries among black refugee children did not differ significantly from their black peers residing in the U.S. Based on these results, cultural differences between black refugees (African) and white refugees (Eastern European) may be an important factor in the risk for untreated caries. Supported by Delta Dental Foundation and NIDCR Grant U54 DE14264