Background <p>More than two years of the Russian-Ukrainian war have resulted in widespread human and economic tragedy. This crisis also affects health status, including oral health.</p> Objective <p>To carry out an exploratory analysis on the extent of caries in Ukrainian war refugee children and adolescents, and in addition to determine whether there was a statistically significant association between caries and age, gender, periodontal health status (using the Periodontal Screening and Recording (PSR) index), self-reported socioeconomic status and Italian language speaking skills.</p> Methods <p>This study used a cross-sectional design, was conducted in Perugia, Italy at the University Dental Clinic (COU) between November 2023 and April 2024 and included 50 children and adolescents between 3 and 18 years old (mean age 9.2 SD 4.6) with Ukrainian citizenship who had left their home country due to the war. The visits were conducted in the presence of a cultural mediator. The visits consisted of two parts: the administration of questionnaires on socio-economic status and communication skills, followed by a dental examination. A logistic regression model was used to identify the factors independently associated (age, sex, PSR, socio-economic status and level of communication) with high DMFT/dmft values.</p> Results <p>The refugees’ mean DMFT/dmft was 3.5 SD 2.5. The multivariate logistic regression model showed that increased PSR (OR 7.71, 95% CI 1.38–22.94, <i>p</i> = 0.020) and low communication (OR 6.09, 95% CI 1.34–27.69, <i>p</i> = 0.019) were independently associated with the risk of having a DMFT/dmft &gt; 4.</p> Conclusions <p>The study findings were worrying in terms of the prevalence and severity of caries, especially in refugee children with a poor level of integration in the host country. This study with its preliminary data provides a starting point to reflect on the need for specific health policies adapted to a complex type of social vulnerability such as refugee children status.</p>