Preventive vs. Restorative Dental Care Needs in Underprivileged Children: A Multi-Site, Community-Based Cross-Sectional Study in Lahore

Abstract

Background: Dental caries and related oral conditions remain major preventable health problems among socioeconomically disadvantaged children, particularly where access to routine preventive dental services is limited. Objective: This study aimed to evaluate and compare preventive and restorative dental care needs among school-going children from an underprivileged urban community in Lahore, Pakistan. Methods: A retrospective secondary analysis was conducted using anonymized data from routine community dental outreach screening of 196 children aged 5–15 years. Clinical indicators included Plaque Index, Gingival Index, demineralization lesions, DMFT/DEFT scores, cavitated lesions, dental pain or sensitivity, active infection, and previous restorations. Behavioral and contextual variables included brushing frequency, sugary snack intake, parental education, and BMI-for-age category. Descriptive statistics, subgroup comparisons, and exploratory binary logistic regression were used to assess factors associated with restorative dental care need. Results: Preventive care needs were identified in 86.2% of children, while restorative care needs were present in 72.4%. Abnormal plaque accumulation affected 82.6%, gingival inflammation 76.4%, demineralization 48.5%, cavitated lesions 69.4%, dental pain or sensitivity 24.0%, and active infection 15.3%. Only 6.1% had previous restorations. Higher Plaque Index, frequent sugary snack intake, brushing less than once daily, and low parental education were significantly associated with greater restorative care need. Conclusion: The findings show a substantial coexistence of early preventable disease and advanced untreated restorative morbidity, supporting integrated school-based oral health strategies combining prevention, parental education, screening, and referral for restorative care