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

Objectives: To describe tooth brushing frequency and its association with a wide range of socioeconomic and behavioral characteristics, using a nationally representative sample of school-aged children in France.

Methods: Our sample included 11,337 students aged from 10 to 16 years, who answered the HBSC questionnaire. Some variables were grouped into composite variables, thus generating scores for: eating habits, health and body, relationships with parents, socioeconomic status (SES) of family, and school life. Multivariate logistic regression analyses were used to study the relationship between these variables and tooth brushing frequency.

Results: Girls were more likely to brush twice a day than boys [adjusted Odds Ratio: aOR 2.47, 95 percent confidence interval CI (1.97; 3.11), aOR 1.89, CI (1.56; 2.29), aOR 1.45, CI (1.25; 1.68) for low, mid, and high school life score, respectively]. Students were more likely to brush twice a day when they had high (versus low) scores for healthy eating habits [aOR = 1.60; 95 percent CI: (1.40; 1.83)], well-being concerning health and body [aOR = 1.61; 95 percent CI: (1.40; 1.86)] and SES [aOR = 1.25; 95 percent CI: (1.09; 1.43)].

Conclusions: We believe that preventive health campaigns should target school and family environments more specifically to reach the most disadvantaged sections of the population and include promotion of whole health. The messages should be designed to efficiently reach adolescents, e.g., by appealing to their maturity, self-esteem, and emotional factors. Through the incorporation of qualitative research elements, identifying the reasons for not brushing twice a day would also help to develop new prevention programs.