Burden of oral disease in Syrian refugee children

A summary of: Joury, E., Meer, R., Chedid, J. et al. Burden of oral diseases and impact of protracted displacement: a cross-sectional study on Syrian refugee children in Lebanon. Br Dent J (2021). https://doi.org/10.1038/s41415-021-2960-9


Conflicts and war crises have been among the most persistent global challenges. According to the United Nations High Commissioner for Refugees (UNHCR), the global population of forcibly displaced people has doubled in the last three decades, increasing from nearly 34 million in 1997 to nearly 80 million in 2019, with more than 25 million of them being refugees.

A protraction situation is defined by UNHCR where 25,000 or more refugees of the same nationality have been displaced in a certain asylum country for five consecutive years or longer. Not much is known regarding the prevalence of paediatric oral diseases in protracted situations. 

The purpose of this study was to determine the prevalence of oral diseases among Syrian refugee children residing in Lebanon and to evaluate its association with the duration of displacement.

Materials and methods:

Data from the Miles for Smiles initiative in Bekaa/Lebanon was used, which included 910 school children from five Syrian refugee primary schools (only Syrian refugees attended these schools). The study included the whole child population (n=910) at these five refugee schools.

A dental examination was carried out to assess the presence of dental caries and abscess. A clinical form was used to gather information on the presence, severity and duration of dental pain. 

The Wong-Baker Revised FACES Pain Rating Scale, a common way of evaluating paediatric pain, was used to measure dental pain. It involves asking children to point to the face that best describes their feelings of current dental pain ranging from ‘happy face’ (score 0; no pain or hurt) to a ‘crying face’ (score 10; pain hurts worst).

Demographics data including age, gender, and duration of displacement were also collected.


Out of the total of 910 children, 823 had complete data. 12.8% of the population were living in protracted displacement (had been displaced for five years or more). 

The burden of oral diseases among Syrian refugee children is shown in Table 1. The majority of children had untreated dental caries (90.2%). 

57% of children reported experiencing current dental pain, with 55% having moderate-to-severe dental pain
(scores 4-10) and 38% having this pain for more than one month. Dental abscess affected 8.9% of the children.

After adjusting for age and gender, children who had been displaced for >5 years were more likely to have a higher number of decayed teeth than those who had been displaced for <5 years. The difference in the number of decayed teeth between children in protracted displacement and those who had been displaced for <5 years was highly statistically significant (Table 2). 

Although children who had been displaced for >5 years were more likely to have dental pain and abscess compared to those who had been displaced for <5 years, these differences were not statistically significant (Table 3).


The prevalence of oral diseases among Syrian refugee children in Lebanon was significant, particularly among those living in protracted situations. Evidence-based, effective public health initiatives are required to improve the oral health of this population.

Research Summary Written By: Safa Shareef, University of Manchester – BDS 3

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