IntroductionSchool children have a high prevalence of oral health problems in Nepal. Socio-demographic factors such as gender, parents’ socioeconomic status, and individual awareness of oral health may have an influence on the occurrence of oral health problems. However, little evidence is available about the oral health problems and their associated factors among school children. Therefore, this study aimed to assess the factors associated with oral health problems among school children in Nepal.MethodologyA cross-sectional study was conducted among school children of grade 7 in 12 schools of Kaski district, Gandaki Province, Nepal. The schools were randomly chosen from urban and semi-urban areas in the district. A total of 669 students participated in the study. Data were collected using a set of questionnaires covering dental health knowledge, socio-demographic characteristics, oral health condition and practices. The factors of poor oral health condition and practices were examined using t-test, one-way Anova, and multiple linear regression.ResultsSchool children who visited health institutions for oral health services and those with parents having higher level education had higher dental health knowledge scores. Total decayed score was higher among those who did not have knowledge that fluoride prevents decay compared to those who had knowledge about it (Have knowledge about fluoride prevents decay: Mean=1.21 (SD=1.54) Vs No knowledge: mean=2.13 (SD=2.13). Females were more likely to have higher DMFT score compared to males (β-coefficient=0.43, 95% CI=0.13, 0.73, P value=0.005) and increase in knowledge score was associated a with a decrease in DMFT score (β-coefficient=-0.09, 95% CI= -0.20, -0.10, P value=0.047).ConclusionThis study found that gender, knowledge score, and parent’s socioeconomic status were the major factors contributing to higher DMFT scores. School children should be provided with regular oral health counseling and promotion activities in schools and oral health screening in schools.