Oral Health Behaviour of Adolescents: a Comparative Study in 35 Countries

SUMMARY This study is part of the Cross-National Survey on Health Behaviour in School-aged Children – World Health Organization Collaborative Study, which started in 1982. Objectives: The aim of this study was to describe the health behaviour patterns related to oral health (toothbrushing and dieting) in cross-national perspective and access its interrelations at the level of individuals and at the level of countries. Materials: The samples represent 11-15-year-old schoolchildren from 32 countries of Europe, Israel, Canada, and the USA in 2001-2002 school-year. Methods: The research was carried out according to the methodology of the HBSC study using the anonymous standardized questionnaire. Frequencies of toothbrushing and consumption of sweets, soft drinks, fruits and vegetables were estimated in the present study. Age standardized data in aggregated samples of 11-15-years-olds were used for the comparisons across countries. Relationships between variables were estimated both at the individual’s level and at the country’s level. Results: The toothbrushing habits apparently were best in Switzerland, Norway and Sweden, as the proportion of children who reported toothbrushing more than once a day was higher than 74% of boys and higher than 84% of girls. The lowest prevalence of recommended toothbrushing (less than 32% of boys and 52% of girls) was in Malta, Lithuania and Finland. There was also a wide range across countries in proportions of daily consumption of fruits, vegetables, sweets and soft drinks. At the individual’s level, in a number of countries, toothbrushing positively correlated with the consumption of fruits and vegetables. At the country’s level such relationships were negligible. Relationships between eating patterns were identified both at the level of individuals and at the level of countries. Conclusions: The study provides some data to suggest that different oral health behaviour profiles exist across countries. Health education should consider these cross-national differences. The risk to oral diseases based on oral health behaviour need to be assessed in future studies.