Oral Health status and Dental Service Utilization among school adolescents of Mohmand Agency, Pakistan using Anderson Model. A cross-sectional study

Introduction: Poor dental health is a public health problem in Pakistan, particularly in underserved regions such as Mohmand Agency, Khyber Pakhtunkhwa, where oral health is neglected compared to infectious diseases, maternal and child health, and nutrition. Limited awareness and inadequate dental facilities have worsened the situation, though improving oral health aligns with SDG3. This study assessed the oral health status of school-going adolescents and identify determinants of dental caries using Andersen’s Behavioral Model. Methods : A cross-sectional survey among 385 adolescents aged 13–18 years was conducted through multistage cluster random sampling. Oral health was measured using DMFT index, while a structured questionnaire collected information on predisposing, enabling, need-based, and behavioral factors. Data were analyzed using SPSS v20.0 with Kruskal-Wallis H and Mann-Whitney U tests with Bonferroni correction. Results : Most participants were male (83%), early adolescents (53.2%), and from low-income households (66.2%),39% had never visited a dentist. The prevalence of dental caries was 97.7%. DMFT was not associated with age (p = 0.095) and education (p = 0.327), but parental income and last dental visit were significantly related to DMFT (p < 0.001). Post hoc tests revealed higher DMFT scores among those from the lowest income group and those who had never visited a dentist. Conclusion : Adolescents exhibited high burden of untreated dental caries, influenced by financial barriers and lack of dental care. The findings underscore the need for oral health promotion, improved service accessibility, and policy interventions to address disparities in underserved regions.