Oral hygiene and sugar consumption among urban and rural adolescents in Ghana

Objectives: The purpose of this study was to compare categories of self-rep orted oral health behavior among adolescents raised in urban and rural area s of Ghana. Methods: Second year students (n=583) aged 14-18 years were sel ected from the five secondary schools in the Awutu-Effutu Senya district, u sing a stratified random sampling procedure. A total of 504 (86%) students completed questionnaires under supervision at school. Results: Cross-tabula tion analyses revealed that most urban and rural residents (97% and 96%) re ported daily tooth brushing, whereas small and moderate proportions reporte d use of toothpicks and intake of sugared snacks, respectively. Multiple lo gistic regression analyses, controlling for gender and parents' education, showed that the socio-regional context (urban/rural) was significantly rela ted to intake of cakes/biscuits (odds ratio (OR)=2.6, 95% CI 1.7-4.4), choc olate/sweets (OR=3.5, 95% CI 2.0-6.0) and use of toothpicks (OR=2.6, 95% CI 1.3-5.5), indicating true differences between urban and rural residents. C onclusion: As predicted, urban residents were more likely than their rural counterparts to use toothpicks and to consume sugared snacks. Among both ur ban and rural residents, males and those having less educated parents repor ted oral hygiene and sugar intake less frequently than did females and the highly educated. Whereas the gender difference with respect to intake of su gared snacks was larger among urban than rural residents, the socio-economi c disparity with respect to use of toothpicks was most pronounced among rur al residents. The results appear to imply that in addition to targeting spe cific oral health behaviors, both individual characteristics and the wider socio-regional context should be addressed when planning oral health interv ention among Ghanaian adolescents.