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

Abstract

The purpose of this study was to compare categories of self-reported oral health behavior among adolescents raised in urban and rural areas of Ghana. Methods: Second year students (n=583) aged 14-18 years were selected from the five secondary schools in the Awutu-Effutu Senya district, using a stratified random sampling procedure. A total of 504 (86%) students completed questionnaires under supervision at school. Results: Cross-tabulation analyses revealed that most urban and rural residents (97% and 96%) reported daily tooth brushing, whereas small and moderate proportions reported use of toothpicks and Intake of sugared snacks, respectively. Multiple logistic regression analyses, controlling for gender and parents' education, showed that the socio-regional context (urban/rural) was significantly related to intake of cakes/biscuits (odds ratio (OR)=2.6, 95% CI 1.7-4.4), chocolate/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. Conclusion: As predicted, urban residents were more likely than their rural counterparts to use toothpicks and to consume sugared snacks. Among both urban and rural residents, males and those having less educated parents reported oral hygiene and sugar intake less frequently than did females and the highly educated. Whereas the gender difference with respect to intake of sugared snacks was larger among urban than rural residents, the socio-economic disparity with respect to use of toothpicks was most pronounced among rural residents. The results appear to imply that in addition to targeting specific oral health behaviors, both individual characteristics and the wider socio-regional context should be addressed when planning oral health intervention among Ghanaian adolescents.