Abstract / Summary
Abstract Background: Sudanese refugee children living in Egypt may experience substantial oral health inequalities because of disrupted access to preventive dental care, financial constraints, and limited healthcare accessibility. However, evidence comparing their oral health-related quality of life (OHRQoL) with that of children from the Egyptian host community remains limited. Objective: To compare caregiver-perceived OHRQoL, oral symptoms, dental visits, caregiver perceptions, perceived barriers to dental care, and clinical oral health status between Sudanese refugee children and Egyptian children, and to identify factors independently associated with poorer OHRQoL. Methods: This comparative cross-sectional study included 192 child–caregiver pairs (96 Sudanese refugee children and 96 Egyptian children) aged 6–12 years. Caregivers completed a structured questionnaire based on domains of the Parental-Caregiver Perceptions Questionnaire, assessing oral symptoms, OHRQoL, dental visits, caregiver perceptions, and barriers to dental care. Clinical examinations recorded DMFT/dmft score, plaque index, and gingival index. Between-group comparisons were performed using chi-square, Monte Carlo Exact, and Mann–Whitney U tests, as appropriate. Multivariable ordinal logistic regression was used to identify factors independently associated with poorer OHRQoL. Results: Sudanese refugee children demonstrated significantly poorer OHRQoL across functional, emotional, and social domains and experienced more frequent oral pain, pain during eating, gingival bleeding, oral malodor, and oral dryness than Egyptian children (all p < 0.05). Preventive dental visits were substantially lower among Sudanese children, whereas pain-driven dental visits, financial barriers, lack of health insurance, and perceived difficulties accessing dental services were significantly more common. Although the two groups had comparable DMFT/dmft scores (p = 0.616), Egyptian children exhibited slightly higher plaque and gingival index scores. In the multivariable ordinal logistic regression model, lack of health insurance emerged as the strongest independent factor associated with poorer OHRQoL (adjusted OR = 34.81, 95% CI: 13.99–86.60; p < 0.001), whereas clinical oral health measures were not independently associated with OHRQoL after adjustment. Conclusions: Sudanese refugee children living in Egypt experience substantially poorer oral health-related quality of life despite having a comparable cumulative dental caries experience to Egyptian children. The findings indicate that healthcare accessibility and financial protection may influence children's everyday oral health experiences more strongly than clinical disease severity alone. Integrating caregiver-reported outcome measures with conventional clinical indicators may provide a more comprehensive assessment of oral health needs and support the development of equitable, culturally appropriate oral health policies and preventive programmes for refugee populations.