Socioeconomic and behavioral determinants of tooth brushing frequency: results from the representative French 2010 HBSC cross-sectional study

Adolescent Toothbrushing and Its Association with Sociodemographic Factors-Time Trends from 1994 to 2018 in Twenty Countries

Regular toothbrushing is the primary self-care method to prevent the most common dental diseases and is considered an important public health indicator. This retrospective observational study aimed to examine cross-national time trends in adolescent toothbrushing behaviour and its association with sociodemographic factors between 1994 and 2018. We studied data from 20 countries that conducted seven surveys of the Health Behaviour in School-aged Children (HBSC) study. Adolescents aged 11, 13 and 15 years responded to questions on their toothbrushing frequency, family affluence and structure. Altogether, reports of 691,559 students were analysed using descriptive statistics and binominal logistic regression. The findings showed an overall positive trend in the prevalence of more-than-once-a-day toothbrushing frequency during the entire study period mainly due to a noticeable increase from 1994 to 2010 (except Denmark and Sweden); this trend continued significantly thereafter in 12 of 20 countries. Across all countries, girls and adolescents from more affluent families were more likely to brush their teeth regularly. These relationships remained unchanged throughout the study period, whereas the age-related difference in toothbrushing prevalence decreased noticeably, and the negative relationship between toothbrushing and living in a non-intact family became evident. While the prevalence of regular toothbrushing among adolescents has increased in recent decades, it is still far behind the recommended level of twice-daily brushing for everyone across all countries. The promotion of toothbrushing needs to start at an early age, with a special focus on boys and adolescents from low-affluence and non-intact families.

Family Related Variables' Influences on Adolescents' Health Based on Health Behaviour in School-Aged Children Database, an AI-Assisted Scoping Review, and Narrative Synthesis

Objects

Health Behaviours in School-aged Children (HBSC) is an international survey programme aiming to investigate adolescents' health behaviours, subjective perception of health status, wellbeing, and the related contextual information. Our scoping review aimed to synthesise the evidence from HBSC about the relationship between family environmental contributors and adolescents' health-related outcomes.

Methods

We searched previous studies from six electronic databases. Two researchers identified the qualified publications independently by abstract and full-text screening with the assistance of an NLP-based AI instrument, ASReview. Publications were included if they were based on HBSC data and investigated the effects of family environment on adolescents' health outcomes. Researches addressed family-related factors as mediators or moderators were also included.

Results

A total of 241 articles were included. Family environmental contributors could be mapped into six categories: (1) Demographic backgrounds (N = 177); (2) General family's psycho-socio functions (N = 44); (3) Parenting behaviours (N = 100); (4) Parental health behaviours (N = 7); (5) Family activities (N = 24); and (6) Siblings (N = 7). Except for 75 papers that assessed family variables as moderators (N = 70) and mediators (N = 7), the others suggested family environment was an independent variable. Only five studies employed the data-driven approach.

Conclusion

Our results suggest most research studies focussed on the influences of family demographic backgrounds on adolescents' health. The researches related to parental health behaviours and siblings are most inadequate. Besides, we recommend further research studies to focus on the mediator/moderator roles of the family, for exploring the deep mechanism of the family's impacts. Also, it would be valuable to consider data-driven analysis more in the future, as HBSC has mass variables and data.

Association of oral bacteria with oral hygiene habits and self-reported gingival bleeding

Aim

To describe associations of gingival bacterial composition and diversity with self‐reported gingival bleeding and oral hygiene habits in a Norwegian regional‐based population.

Materials and Methods

We examined the microbiome composition of the gingival fluid (16S amplicon sequencing) in 484 adult participants (47% females; median age 28 years) in the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) study in Bergen, Norway. We explored bacterial diversity and abundance differences by the community periodontal index score, self‐reported frequency of gingival bleeding, and oral hygiene habits.

Results

Gingival bacterial diversity increased with increasing frequency of self‐reported gingival bleeding, with higher Shannon diversity index for “always” β = 0.51 and “often” β = 0.75 (p < .001) compared to “never” gingival bleeding. Frequent gingival bleeding was associated with higher abundance of several bacteria such as Porphyromonas endodontalis, Treponema denticola, and Fretibacterium spp., but lower abundance of bacteria within the gram‐positive phyla Firmicutes and Actinobacteria. Flossing and rinsing with mouthwash twice daily were associated with higher total abundance of bacteria in the Proteobacteria phylum but with lower bacterial diversity compared to those who never flossed or never used mouthwash.

Conclusions

A high frequency of self‐reported gingival bleeding was associated with higher bacterial diversity than found in participants reporting no gingival bleeding and with higher total abundance of known periodontal pathogens such as Porphyromonas spp., Treponema spp., and Bacteroides spp.

Toothbrushing and related factors among high school students in the Southeast of Iran: A cross-sectional study

INTRODUCTION

Dental caries is one of the most common problems in student, and tooth brushing at least twice a day is one of the preventive measures of dental caries. This study aimed to determine the frequency of daily brushing and its related factors among high school students in the southeast of Iran based on the Health Action Process Approach (HAPA).

METHODS

In this cross-sectional study, 2045 high school students of 13-15 years from urban areas of Zahedan in the southeast of Iran with multistage random sampling were selected. A self-administered questionnaire was used to assess demographic background, psychosocial constructs of the HAPA and daily brushing frequency. Binary logistic regression analysis was performed to determine predictors of daily brushing.

RESULTS

Only 18% of participants reported tooth brushing at least twice a day, which is the desired brushing behaviour. Multivariate regression showed that increased odds of daily brushing associated with gender (OR = 2.38, 95% CI 1.84-3.08), mother education (OR = 2.27, 95% CI 1.62-3.18), father job (OR = 2.24, 95% CI 1.20-4.19), task self-efficacy (OR = 1.24, 95% CI 1.08-1.42), action planning (OR = 1.10, 95% CI 1.02-1.19) and maintenance self-efficacy (OR = 1.20, 95% CI 1.13- 1.27).

CONCLUSION

The brushing behaviour of students needs to be taken seriously in Zahedan. Motivational and volitional constructs of the HAPA include task self-efficacy, action planning, and maintenance self-efficacy could be considered in intervention programmes targeting increase adolescent brushing.

Changes in tooth brushing frequency and its associated factors from 2006 to 2014 among French adolescents: Results from three repeated cross sectional HBSC studies

OBJECTIVES

This study aimed to evaluate in the changes in the percentage of adolescents who brush their teeth twice a day and the association with socio-economic status and health behaviors between 2006, 2010 and 2014 among adolescents from the French cross-sectional studies of the Health Behavior in School-aged Children (HBSC) survey.

METHODS

Our sample included 18727 adolescents aged 11, 13 or 15 years old (y/o). The relationship between toothbrushing frequency (TBF) and eating habits, health and socio-economic status markers, family status, school perception, substance use, sedentary lifestyle and physical activity, together with their evolution over the 3 studies, were investigated using multivariate logistic regression.

RESULTS

The proportion of adolescents brushing twice a day increased from 68.8% in 2006 to 70.8% in 2010 and 78.8% in 2014 (p<0.0001). Notable associated factors (p<0.0001) were: being a girl (adjusted Odds Ratio = 1.5) and, even more, an older girl (aOR 1.5 for 15 y/o vs 11 y/o girls), having breakfast (aOR 1.4) and eating fruits daily (aOR 1.6), excellent perceived health (aOR 1.2), obesity or overweight (aOR 0.6), being bullied at school (aOR 0.8), and perceived family wealth (aOR 1.4 for High vs Low). No impact from any associated factor changed over the 3 studies.

CONCLUSIONS

Among French adolescents, TBF improved from 2006 to 2014. TBF was significantly associated with other health behaviors. These associations stayed similar in 2006, 2010 and 2010. This increase in TBF may be linked with global prevention programs developed during this time period. These programs should be maintained and associated with more specific ones targeting and adapted to disadvantaged populations, in order to reduce inequalities in oral hygiene and oral health.

Predictors of oral health promotion behaviors among elementary school children: Examination of an extended social cognitive theory

BACKGROUND

Brushing teeth with fluoride-containing toothpaste and flossing are considered as effective solutions for preventing dental caries and periodontal diseases.

AIM

The aim of this study was to use the promoted social cognitive theory (SCT) to investigate factors influencing adherence to oral hygiene behaviors by elementary school children.

DESIGN

In this cross-sectional study, 988 elementary school children were chosen using the multistage cluster sampling method. Data were collected using the SCT scale, and its validity and reliability were confirmed. Theoretical models were examined using the structural equation modeling.

RESULTS

The SCT explained 50% of the variance in brushing with fluoridated toothpaste and 55.6% of the variance in flossing behaviors. The total effect of family environment (β = .60, P < .05), self-efficacy in overcoming impediments (β = .50, P < .05), and emotional coping (β = .40, P < .05) variables in the conceptual model had significantly influenced tooth brushing behavior. The total effect of self-efficacy (β = .79, P < .05), family environment (β = .41, P < .05), and situational perception (β = .35, P < .05) variables of the conceptual model significantly influenced the flossing behavior.

CONCLUSIONS

The SCT, self-efficacy, and family environment were strongly associated with brushing and flossing behaviors. Therefore, supportive family environments should be considered as one of the top contributors to successful oral health promotion.

Lifestyle and psychosocial correlates of oral hygiene practice among Indonesian adolescents

Poor oral hygiene leads to poor oral health, which in turn has negative impacts on overall health and quality of life. This study aimed to evaluate the prevalence and associated factors of oral hygiene practice among school-going adolescents in Indonesia. Secondary analysis of cross-sectional, nationally representative data from the 2015 Indonesia Global School-based Health Survey, covering 11,142 students aged 11-18 years, was performed. Multiple logistic regression was employed to explore associations between lifestyle, psychosocial factors, and tooth-brushing frequency. Around 10.8% of the students brushed their teeth less frequently than the recommended twice-daily regimen. Male gender, lower socio-economic status, poor dietary practice, longer sedentary time, drug use, psychological distress, less peer support, and no parental support were associated with infrequent tooth brushing. The findings support the need to integrate oral health promotion into general health actions that target families, schools, and social environments of adolescents to develop healthier habits.

Educational Attainment and Self-Rated Oral Health among American Older Adults: Hispanics' Diminished Returns

Background: Minorities’ diminished returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES), particularly educational attainment, on the health of non-Whites compared to Whites. Aim: Using a nationally representative sample, we aimed to investigate ethnic differences in the effect of SES (educational attainment) on the self-rated oral health of Hispanic older adults in the US. Methods: This study analyzed the University of Michigan National Poll on Healthy Aging (UM-NPHA) 2017 data, which included 2131 older adults who were 50 to 80 years old (202 Hispanics and 1929 non-Hispanics). Ethnicity, race, educational attainment (SES), age, gender, employment, retirement, and self-rated oral health (single item) were measured. Logistic regressions were applied for data analysis. Results: High educational attainment was associated with lower odds of poor oral health in the pooled sample, net of all covariates. The effect of educational attainment on poor self-rated oral health was found to be weaker for Hispanics than for non-Hispanics. Conclusion: We observed MDRs of educational attainment (SES) on oral health for Hispanic older adults. In other words, compared to non-Hispanics, Hispanics gain less oral health from their educational attainment (SES).