Cárie dentária, sequelas clínicas e necessidade de tratamento em pré-escolares residentes em localidades ribeirinhas do Paraná do Paratari, Manacapuru, Amazonas

Abstract

Dental caries affects a large number of preschool children worldwide and remains one of the most prevalent chronic diseases of childhood, disproportionately affecting socially vulnerable populations, including rural riverside communities. This study aimed to evaluate the oral health conditions of preschool children aged three to five years living in riverside communities of Paraná do Paratari, in the municipality of Manacapuru, Amazonas, Brazil. A population-based cross-sectional household study was conducted among preschool children who had lived in the territory for at least one year. Socioeconomic and demographic information, dietary habits, self-reported oral morbidity, and use of dental services were obtained through interviews with caregivers, carried out between October 2024 and October 2025. Dental caries experience in primary teeth, clinical consequences of untreated caries, and dental treatment needs were assessed through intraoral clinical examinations. Data were recorded using electronic forms developed on the REDCap platform and subsequently exported for statistical analysis. Descriptive analyses were performed, followed by path analysis to investigate direct and indirect mechanisms associated with unmet dental treatment needs. Only one-third of the children were caries-free, and 40.7% reported dental pain in the previous six months. The mean dmft index was 2.69 (±3.00), with a predominance of the decayed component, and 35.2% of the preschoolers presented pulpal involvement. Two-thirds of the children had at least one unmet dental treatment need. Consumption of sugary foods and beverages was reported by more than 80% of the preschoolers, and 59.3% had never visited a dentist. Path analysis indicated that unmet dental treatment needs were directly associated with older child age, higher consumption of sugary foods and beverages, and poorer access to dental services. Better housing conditions were associated with a lower need. Additionally, socioeconomic factors, family income and maternal education, influenced treatment needs indirectly through household characteristics and dietary behaviors. These findings highlight the relationship between structural and behavioral determinants shaping oral health outcomes among preschool children living in rural riverside communities. The study reveals a high burden of oral disease and substantial unmet dental treatment needs in this population. Expanding access to dental care and implementing intersectoral health promotion strategies that consider territorial specificities and social determinants are essential to improve oral health conditions among preschool children in rural riverside localities.