Oral Health Behaviors among Schoolchildren in Western Iran: Determinants and Inequality

Introduction: Little information exists on the status of oral hygiene behavior (OHB) and socioeconomic inequalities in developing countries like Iran. The aim of this study was to assess OHB and its determinants and socioeconomic inequality among schoolchildren in western Iran during 2018.

Methods: A cross-sectional survey was conducted on 1,457 students aged 12-15 years living in Kermanshah city, western Iran. We used multistage sampling to select the samples. A self-administrated questionnaire was used to collect data on OHB, sociodemographic characteristics, and economic status of the households of students. Multivariate logistic regression was used to examine the association between OHB and its determinants. We used the relative concentration index, normalized (RCIn) and a concentration curve (CC) to examine socioeconomic-related inequality in OHB.

Results: The study indicated that crude and age-adjusted prevalence of good OHB was 14.61% (95% CI 12.89%-16.53%) and 15.17% (95% CI 13.22%-17.35%), respectively. Logistic regression analysis showed that sex, mother's education, socioeconomic status, and oral health literacy had a statistically significant positive impact on OHB. RCIn (0.2582, 95% CI0.1770-0.3395) values and the CC indicated that good OHB was more concentrated among the richer children.

Conclusion: This study provides evidence that good OHB was less prevalent, signifying that oral health remains a public-health concern in Iran. Effective polices aimed at improving the socioeconomic status of households and mother's education can contribute positively and to the prevention of oral disorders among schoolchildren.