Oral conditions play a major role in shaping everyday well-being, positioning them as a priority for worldwide health initiatives. This investigation outlines oral health patterns, perceptions, and clinical status among residents of Tanzania’s Rorya district to better identify obstacles to care. To measure clinical oral status, adult participants underwent intraoral assessments documenting Decayed, Missing, and Filled Teeth (DMFT) and the Comprehensive Periodontal Inflammatory Burden Index (CPBI). Measures of Oral Health-Related Quality of Life (OHRQoL) and qualitative interviews were used to capture hygiene-related behaviors and beliefs. Quantitative results were processed using two-sample t-tests and Pearson statistics, while interview data were evaluated with NVIVO.A targeted sample of n = 139 individuals who reported living in Burere (n = 32), Nyambogo (n = 52), or Roche (n = 55) was included. Females (n = 67; x¯ = 7.1; SD = 5.4; p < 0.05) demonstrated significantly higher DMFT values compared to males (n = 72; x¯ = 3.7; SD = 3.9). Parallel findings were observed for OHRQoL, where women (n = 67; x¯ = 12.10; SD = 14; p < 0.05) exceeded men (n = 72; x¯ = 10.16; SD = 3). In contrast, mean CPBI was greater among males (x¯ = 3.8; SD = 1.5; p < 0.05) than females (x¯ = 3.0; SD = 1.3). Older adults showed elevated GI and PISA values, whereas participants aged 20–30 had the highest average DMFT. The qualitative interviews produced three main thematic categories: “pearls of laughter guarded by wisdom teeth,” “whispered tales of oral tides and communal echoes,” and “tales of the tooth fairy.” Within this region, essential oral self-care behaviors are often neglected, largely due to inequitable access to dental resources, a pattern reflected in the clinical indicators. Correcting these disparities represents an important opportunity to enhance health and quality of life. The marked differences in outcomes across gender and age further emphasize the need for targeted health programs.
