{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:25:24Z","timestamp":1781198724131,"version":"3.54.1"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. Additionally, it assessed the association between systemic factors, such as nutritional status and psychological conditions, and the severity of oro-dental lesions, with the goal of informing future preventive strategies and public health interventions. Methods: A retrospective analysis was conducted on 333 pediatric patients diagnosed with dental neglect. Clinical data were collected from two centers between 2020 and 2024. Oral health status, socio-demographic characteristics, and psychological conditions were evaluated. Statistical analyses included Fisher\u2019s Exact Test, Mann\u2013Whitney U Test, and Bonferroni-adjusted Z-tests, with significance set at p \u2264 0.05. Results: Among the 333 participants, 52.9% were male, with a mean age of 8.75 \u00b1 3.29 years. Most children (81.7%) resided in rural areas, and 55.6% were first-born. Carious lesions were identified in 100% of cases, with 54.7% showing complications such as endodontic pathology. Poor oral hygiene was reported in 99.1% of children, while 58.6% presented signs of periodontal disease and 37.2% reported spontaneous gingival bleeding. Acute pain was experienced by 40.2% of participants. Nutritional issues were prevalent, with 24.3% classified as obese and 21.6% as malnourished. Significant associations were found between lesion severity and both psychological disorders (p &lt; 0.001) and malnutrition (p &lt; 0.001). Conclusions: This study identifies untreated carious lesions, poor oral hygiene, acute dental pain, and oro-dental trauma as key clinical indicators of pediatric dental neglect, with rural residency and limited education as significant socio-demographic risk factors. The findings highlight the urgent need for integrated, community-based strategies, including school-based screenings, parental education, and referral pathways, to improve early detection and prevention in Romania.<\/jats:p>","DOI":"10.3390\/children12091266","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T08:37:39Z","timestamp":1758530259000},"page":"1266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oro-Dental Characteristics Associated with Pediatric Dental Neglect: A Retrospective Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Anamaria Violeta","family":"\u021au\u021buianu","sequence":"first","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Pia\u021ba 1 Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7275-9986","authenticated-orcid":false,"given":"Abel Emanuel","family":"Moca","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Pia\u021ba 1 Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"\u0218tef\u0103nescu","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Pia\u021ba 1 Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4555-1364","authenticated-orcid":false,"given":"Dan Alexandru","family":"Sl\u0103vescu","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Pia\u021ba 1 Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucian Roman","family":"\u0218ipo\u0219","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Pia\u021ba 1 Decembrie Street, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horia","family":"C\u00e2lniceanu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babe\u0219 University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-7236","authenticated-orcid":false,"given":"Anca","family":"Ionel","sequence":"additional","affiliation":[{"name":"Department of Oral Rehabilitation, Faculty of Dental Medicine, Iuliu Ha\u021bieganu University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s40653-019-0247-y","article-title":"Dental Neglect","volume":"13","author":"Spiller","year":"2020","journal-title":"J. Child Adolesc. Trauma"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Busuttil, A., and Keeling, J.W. (2008). Paediatric Forensic Medicine and Pathology, CRC Press.","DOI":"10.1201\/b13186"},{"key":"ref_3","first-page":"243","article-title":"Combating child abuse: The role of a dentist","volume":"11","author":"Mathur","year":"2013","journal-title":"Oral Health Prev. Dent."},{"key":"ref_4","unstructured":"Royal College of Paediatrics and Child Health (2024). Child Protection Evidence: Dental Neglect. Systematic Review, Royal College of Paediatrics and Child Health. Available online: https:\/\/childprotection.rcpch.ac.uk\/child-protection-evidence\/dental-neglect-systematic-review\/."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Moca, A.E., Iurcov, R., Ciavoi, G., Moca, R.T., and \u0218ipo\u0219, L.R. (2023). Pediatric Dental Emergencies during the COVID-19 Pandemic in Romania: A Retrospective Study. Children, 10.","DOI":"10.3390\/children10050807"},{"key":"ref_6","unstructured":"American Academy of Pediatric Dentistry (2024). Definition of Dental Neglect. The Reference Manual of Pediatric Dentistry, American Academy of Pediatric Dentistry."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1080\/10550490701525509","article-title":"Child neglect and oral health problems in offspring of substance-abusing fathers","volume":"16","author":"Mezzich","year":"2007","journal-title":"Am. J. Addict."},{"key":"ref_8","unstructured":"Ol\u0103rescu, V., and Veleanovici, A. (2015). Perspective Psihosociale ale Abuzului \u0219i Neglij\u0103rii Copilului, Institutul de \u0218tiin\u021be ale Educa\u021biei."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Moca, A.E., Juncar, R.I., Moca, R.T., Juncar, M., Marton, R.D., and Vaida, L.L. (2024). Parental Knowledge, Attitudes, and Practices Regarding Early Childhood Caries in Bihor, Romania: A Cross-Sectional Study. Children, 11.","DOI":"10.3390\/children11091131"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"172","DOI":"10.70921\/medev.v30i1.916","article-title":"Parents\u2019 Perspective on Their Children\u2019s Dental Treatments Covered by Public Health Insurance in Romania\u2014A Pilot Study","volume":"30","author":"Georgescu","year":"2024","journal-title":"Med. Evol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1002\/j.0022-0337.2006.70.2.tb04074.x","article-title":"Oral health attitudes, knowledge, and behavior among school children in North Jordan","volume":"70","author":"Saeed","year":"2006","journal-title":"J Dent Educ."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2471\/BLT.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"Onyango","year":"2007","journal-title":"Bull. World Health Organ."},{"key":"ref_13","unstructured":"World Health Organization (2008). Training Course on Child Growth Assessment, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241595070."},{"key":"ref_14","first-page":"482","article-title":"Oral health care in Europe: A study with a focus on Romania","volume":"19","year":"2024","journal-title":"World J. Biol. Pharm. Health Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.4103\/ijcm.IJCM_62_18","article-title":"Are Body Image Issues Affecting Our Adolescents? A Cross-Sectional Study among College Going Adolescent Girls","volume":"43","author":"Ganesan","year":"2018","journal-title":"Indian J. Community Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Papageorgiou, A., Fisher, C., and Cross, D. (2022). \u201cWhy Don\u2019t I Look like Her?\u201d How Adolescent Girls View Social Media and Its Connection to Body Image. BMC Womens Health, 22.","DOI":"10.1186\/s12905-022-01845-4"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104179","DOI":"10.1016\/j.chiabu.2019.104179","article-title":"Trends in US Physician Diagnosis of Child Physical Abuse and Neglect Injuries, 2006\u20132014","volume":"98","author":"Zins","year":"2019","journal-title":"Child Abus. Negl."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Liu, M., Yun, Q., Zhao, M., Chen, W., Zhang, H., Hou, W., and Chang, C. (2021). Association of Siblings\u2019 Presence and Oral Health-Related Quality of Life among Children: A Cross-Sectional Study. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01526-y"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Bradbury-Jones, C., Innes, N., Evans, D., Ballantine, F., and Taylor, J. (2013). Dental neglect as a marker of broader neglect: A qualitative investigation of public health nurses\u2019 assessments of oral health in preschool children. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-370"},{"key":"ref_20","unstructured":"Government of Romania (2025, July 23). Strategia Na\u021bional\u0103 \u00een Domeniul Drogurilor 2022\u20132026, Anexa 1\u201315, Available online: https:\/\/sgg.gov.ro\/1\/wp-content\/uploads\/2022\/03\/ANEXA-1-15.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jdent.2013.10.010","article-title":"Characteristics of child dental neglect: A systematic review","volume":"42","author":"Bhatia","year":"2014","journal-title":"J. Dent."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/j.1752-7325.2007.00077.x","article-title":"Prevalence of Early Childhood Caries in a Population of Children with History of Maltreatment","volume":"68","author":"Lawrence","year":"2008","journal-title":"J. Public Health Dent."},{"key":"ref_23","first-page":"120","article-title":"Dental Pain in Children: Pharmacological Management","volume":"26","author":"Mohn","year":"2025","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/edt.12389","article-title":"World Traumatic Dental Injury Prevalence and Incidence, a Meta-Analysis\u2014One Billion Living People Have Had Traumatic Dental Injuries","volume":"34","author":"Petti","year":"2018","journal-title":"Dent. Traumatol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dumitrescu, R., Sava-Rosianu, R., Jumanca, D., Balean, O., Damian, L.-R., Fratila, A.D., Maricutoiu, L., Hajdu, A.I., Focht, R., and Dumitrache, M.A. (2022). The Impact of Parental Education on Schoolchildren\u2019s Oral Health\u2014A Multicenter Cross-Sectional Study in Romania. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191711102"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chen, H., Zhang, R., Cheng, R., Xu, T., Zhang, T., Hong, X., Zhao, X., Wu, Y., Cheng, L., and Hu, T. (2020). Gingival Bleeding and Calculus among 12-Year-Old Chinese Adolescents: A Multilevel Analysis. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01125-3"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1002\/car.2419","article-title":"Clinical audit of children\u2019s missed dental appointments in a city-wide salaried community dental service in relation to guidance on when to suspect child maltreatment","volume":"26","author":"Harris","year":"2017","journal-title":"Child Abus. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/0976-9668.107257","article-title":"Early childhood caries update: A review of causes, diagnoses and treatments","volume":"4","author":"Dalli","year":"2013","journal-title":"J. Nat. Sci. Biol. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s40368-013-0089-5","article-title":"Risk factors for early childhood caries: A case-control study","volume":"14","author":"Mahesh","year":"2013","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kvesi\u0107, A.J., Hrelja, M., Lovri\u0107, \u017d., \u0160imunovi\u0107, L., \u0160piljak, B., Supina, N., Vrani\u0107, L., and Vrani\u0107, D.N. (2023). Possible Risk Factors for Dental Fear and Anxiety in Children Who Suffered Traumatic Dental Injury. Dent. J., 11.","DOI":"10.3390\/dj11080190"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Tiwari, T., Kelly, A., Randall, C.L., Tranby, E., and Franstve-Hawley, J. (2022). Association Between Mental Health and Oral Health Status and Care Utilization. Front. Oral Health, 2.","DOI":"10.3389\/froh.2021.732882"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/cdoe.12086","article-title":"Impact of untreated dental caries on quality of life of preschool children: Different stages and activity","volume":"42","author":"Pordeus","year":"2014","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Motoc, G.V., Juncar, R.I., Moca, A.E., Motoc, O., Moca, R.T., \u021aig, I.A., Vaida, L.L., and Juncar, M. (2023). The Relationship between Dietary Habits and Periodontal Pathogens in a Sample of Romanian Children and Adolescents: A Cross-Sectional Study. Children, 10.","DOI":"10.3390\/children10111779"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Natarajan, P., Madanian, S., and Marshall, S. (2025). Investigating the Link between Oral Health Conditions and Systemic Diseases: A Cross-Sectional Analysis. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-92523-6"},{"key":"ref_35","first-page":"453","article-title":"Does Oral Health Influence School Performance and School Attendance? A Systematic Review and Meta-Analysis","volume":"28","author":"Rebelo","year":"2018","journal-title":"Int. J. Paediatr. Dent."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:46:35Z","timestamp":1760035595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,21]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["children12091266"],"URL":"https:\/\/doi.org\/10.3390\/children12091266","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,21]]}}}