Unmet Dental Treatment Needs and Barriers to Oral Healthcare among Children with Hematologic Malignancies: A Cross-Sectional Study from Iran with Global Implications

Background Children with hematologic malignancies face increased oral health risks due to immunosuppression, chemotherapy, and systemic vulnerabilities. Despite this, unmet dental treatment needs (UTN) remain poorly characterized, particularly in low- and middle-income countries (LMICs). Objectives This study assessed the prevalence of UTN and identified key barriers to dental care among pediatric oncology patients in southeastern Iran, positioning findings within the global context of oral health disparities. Methods In this descriptive-analytical cross-sectional study, 109 children aged 1–18 years with confirmed hematologic malignancies attending the pediatric hematology ward of Imam Ali Hospital, Zahedan (2024), were examined. Oral health was assessed using DMFT/dmft indices following WHO guidelines. A structured questionnaire captured sociodemographic characteristics and barriers to dental care. UTN was calculated as the proportion of decayed teeth to total dmft/DMFT. Associations between UTN, barriers, and background variables were analyzed using chi-square tests (SPSS v.26, α = 0.05). Results Mean DMFT was 4.88 (SD = 3.11) and mean dmft was 4.50 (SD = 4.20). Overall, 81.6% of children had unmet dental treatment needs. The most common barriers were financial constraints (48.3%), parental indifference (20.2%), and lack of access (10.1%). UTN was significantly associated with age (highest in 7–12 years, 97.1%), parental education, family income, disease duration, and frequency of sweet consumption (p < 0.05), but not with gender or frequency of toothbrushing. Conclusions Pediatric oncology patients in Iran exhibit alarmingly high levels of UTN, largely driven by financial and behavioral barriers. Our findings highlight the urgent need for integrating preventive dental care into oncology treatment pathways globally, particularly in LMICs, through strategies such as insurance expansion, parental education, and strengthening oral health infrastructure to improve quality of life in this vulnerable population.