Dental caries experience across dentition stages in Bulgarian children with neurodevelopmental disorders: the role of ethnicity, diagnosis, and care environment

This cross-sectional study aimed to evaluate dental caries experience across dentition stages in Bulgarian children with neurodevelopmental disorders and to assess the influence of age, diagnosis, ethnicity, and caregiving environment on caries indices. A total of 120 children and adolescents with neurodevelopmental or neurological conditions were included. Participants were stratified into four age groups corresponding to primary, mixed, and permanent dentition stages. Caries experience was assessed using dmft and DMFT indices. Sociodemographic and clinical variables included age, sex, ethnicity, diagnosis, caregiving environment, parental age, oral hygiene practices, and dental attendance. Normality was assessed using the Shapiro–Wilk test. As data were non-normally distributed, non-parametric tests were applied, including Kruskal–Wallis H test, Mann–Whitney U test, and Spearman’s rank correlation. Statistical significance was set at p < 0.05. Caries experience differed significantly across dentition stages. DMFT values increased progressively with age and showed a strong positive correlation with age, indicating cumulative caries burden in permanent dentition. In contrast, dmft values were not significantly associated with age. A significant overall association between diagnosis and DMFT was observed, although no pairwise differences were identified. Ethnicity was associated with DMFT, with higher values among Roma children compared to Bulgarian and Turkish children. Caregiving environment influenced caries experience during mixed dentition, with institutionalized children showing significantly higher DMFT values than those in family-based care. No significant differences were observed for dmft in primary dentition. Caries burden in children with neurodevelopmental disorders is primarily influenced by age and social determinants rather than diagnosis alone. Increased vulnerability in permanent dentition, particularly among socially disadvantaged and institutionalized children, highlights the need for targeted, dentition-specific preventive strategies. Not applicable.