Toothbrushing frequency among children and adolescents in 72 countries: Findings from the Global School-based Student Health Survey.

BACKGROUND: Toothbrushing twice daily is essential for maintaining oral hygiene, which is a cornerstone of overall health. This is particularly important during childhood and adolescence, when lifelong habits are established. Nevertheless, many children and adolescents worldwide face challenges in maintaining good oral health due to limited access to resources and education. OBJECTIVES: This study used nationally representative samples from the Global School-based Student Health Survey (GSHS) (2010-2019) to determine the frequency of toothbrushing among school-going students (N = 266,113) in 72 countries. MATERIAL AND METHODS: The country-specific sample size ranged from 130 in Tokelau to 25,408 in Malaysia. The outcome variable was the frequency of brushing or cleaning teeth once daily within the past 30 days prior to the survey. Bivariate analysis was conducted following a descriptive study to determine the frequency of toothbrushing or cleaning across different age groups (≤12, 13, 14, 15, ≥16 years), sexes, World Health Organization (WHO) regions, and gross domestic product (GDP) per capita quintiles. RESULTS: The overall proportion of males to females in the sample was 50.9:49.1. In 45 countries or territories (62.5%), the proportion of participants who reported brushing their teeth at least once a day was above 90%. Participants from 10 countries or territories (13.9%) reported never or rarely brushing their teeth. In 69 countries or territories (95.8%), male students were more likely than female students to never or rarely brush their teeth. The highest rate of individuals who never or rarely brush their teeth (32.1%) was reported in the Eastern Mediterranean Region. In comparison, the Region of the Americas had the highest frequency of brushing twice or more daily (82.9%). CONCLUSIONS: Educational interventions focused on dental health implemented in schools and aimed at early adolescents have the potential to promote the formation of healthy habits, which may lead to improved well-being over both short and long terms.

The association between body mass index and abdominal obesity with hypertension among South Asian population: findings from nationally representative surveys.

OBJECTIVE: This study aimed to determine the association between body mass index (BMI) and abdominal obesity with hypertension among the South Asian adults (18-69 years). METHODS: This study utilized the nationally representative WHO STEPwise approach to surveillance data (n = 24,413) from Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka. Hypertension was defined as having a systolic blood pressure of 140 mmHg or higher, a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive medications. A waist circumference ≥ 90 cm in men and ≥ 80 cm in women was considered as abdominal obesity. BMI was categorized according to Asia-specific cutoff and overweight was defined as BMI of 23.0-27.5 kg/m2 and obesity was defined as BMI ≥ 27.5 kg/m2. Multivariable logistic regression analyses were conducted to identify the association between BMI and abdominal obesity with hypertension. The odds ratio (OR) with a 95% confidence interval (CI) was reported. RESULTS: Abdominal obesity increased the odds of hypertension 31%-105% compared to those who did not have abdominal obesity (OR: Afghanistan: 2.05; 95% CI: 1.27-3.31; Bangladesh: 1.55; 95% CI: 1.18-2.04; Bhutan: 1.31; 95% CI: 1.03-1.66; Nepal: 1.69; 95% CI: 1.31-2.18; Sri Lanka:1.55; 95% CI: 1.23-1.95). The odds increased among participants with both overweight/obesity and abdominal obesity. In all five countries under study, participants with both overweight and abdominal obesity (OR: Afghanistan: 2.75; 95% CI: 1.75-4.34; Bangladesh: 2.53; 95% CI: 1.90-3.37; Bhutan: 2.22; 95% CI: 1.64-3.00; Nepal: 2.08; 95% CI: 1.54-2.81; Sri Lanka: 2.29; 95% CI: 1.77-2.98), as well as those with obesity and abdominal obesity (OR: Afghanistan: 6.94; 95% CI: 4.68-10.30; Bangladesh: 2.95; 95% CI: 2.19-3.97; Bhutan: 3.02; 95% CI: 2.23-4.09; Nepal: 4.40; 95% CI: 3.05-6.34; Sri Lanka: 3.96; 95% CI: 2.94-5.32), exhibited higher odds of having hypertension as compared to participants with a normal BMI and no abdominal obesity. CONCLUSION: Having both abdominal obesity and overweight/obesity increased the odds of hypertension among South Asian adults. Preventing overweight/obesity and abdominal obesity is necessary for preventing the burden of hypertension in South Asia.