Factors predicting oral health behaviors among students age 13–15 years in Shushtar city, Iran

Marashi et al. BMC Oral Health (2023) 23:691 https://doi.org/10.1186/s12903-023-03363-7 BMC Oral Health Open Access RESEARCH Factors predicting oral health behaviors among students age 13–15 years in Shushtar city, Iran Seyedeh Zahra Marashi1, Alireza Hidarnia1*, Seyedeh Somayeh Kazemi2* and Fatemeh Zarei1 Abstract Background Tooth decay and other oral health (periodontal) diseases are highly prevalent worldwide and present a significant economic burden. Oral health is particularly important for adolescents, as the World Health Organization has identified tooth decay as one of the most pressing global health issues. This study aims to identify predictors of oral health behaviors among students aged 13–15 years in the city of Shushtar, Iran. Methods The present research is a cross-sectional study that was conducted during the summer of 2022 on 415 adolescents from the first secondary school in Shushtar. Two standard questionnaires were used to collect data, consisting of demographic information and questions related to measuring awareness, attitude, performance, and self-efficacy regarding oral health behaviors among adolescents. The collected data was analyzed using SPSS 22 statistical software through descriptive statistics, Pearson correlation, and regression analysis. Results The average scores for awareness, attitude, self-efficacy in brushing teeth, self-efficacy in flossing, selfefficacy in going to the dentist, and adolescents’ performance on oral health behaviors are 5.72 ± 2.06, 36.40 ± 6.36, 25.40 ± 7.49, 14.15 ± 6.06, 15.80 ± 5.59, and 14.01 ± 4.02, respectively. Conclusion Based on the results of this study, it can be concluded that adolescents have low levels of awareness, performance, self-efficacy, and a positive attitude towards oral health. Considering the significance of adolescence as a stage for shaping oral health behaviors and their impact on adulthood, it is recommended to increase awareness among adolescents and improve their health behaviors by conducting educational classes in schools. Keywords Oral health, Adolescents, Shushtar *Correspondence: Alireza Hidarnia Seyedeh Somayeh Kazemi 1 Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 2 Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Marashi et al. BMC Oral Health (2023) 23:691 Background Oral health is an essential component of overall health for every individual. It can impact one’s overall health by causing toothache, difficulty in eating, and changes in speech that affect the quality of life [1, 2]. Oral health care should consist of safe, consistent, diverse, accessible, cost-effective, and high-quality care that prevents or eliminates disease, pain, and infection. The most crucial index that indicates the level of people suffering from caries is related to the DMFT1 index. To calculate the DMFT of a community, the number of decayed, filled, and extracted teeth of the individuals in that community is counted, and the average is calculated [3–7]. Tooth decay and other oral health (periodontal) diseases have a high global prevalence and are considered a significant economic burden [8]. Unlike other infectious diseases, they cannot be stopped by taking antibiotics and can affect numerous teeth in a short duration. The World Health Organization (WHO) considers oral health as a prerequisite for maintaining public health throughout one’s life and emphasizes its importance more than ever [9, 10]. The period of transition from childhood to adulthood is associated with many changes, including physical, sexual, and psycho-social alterations, and unfortunately, neglecting healthcare, including oral health care, has become prevalent during this time [11, 12]. In this period, independence from parents increases, leading to changes in behavior, such as eating habits, smoking, health behaviors, lifestyle, which can all impact oral health and create lifelong habits [13]. Oral health is so vital to the adolescent age group that the WHO has declared tooth decay as one of the most critical health problems in the world, with a prevalence of 60–90% among school students. Additionally, oral health diseases affect nearly 3.5 billion people globally [12, 14, 15]. A study conducted in collaboration with the WHO and the Ministry of Health showed that the DMFT index in Iran is 67.1%, with girls having a higher index than boys, and half of the students refuse to brush their teeth. Studies in Ahvaz demonstrated that tooth decay is more prevalent among girls, and most students, particularly boys, are at high risk of tooth decay [16–18]. In addition to non-behavioral factors such as the shape and form of teeth, placement of teeth, type of teeth, etc., and genetics, hygiene behaviors in the field of oral health, including brushing at least twice a day, using dental floss, using mouthwash, and undergoing dental examinations, are essential for improving oral health, preventing and controlling tooth decay and other oral health (periodontal) diseases [19–21]. 1 Decayed, Missing, and Filled Teeth (DMFT). Page 2 of 7 It should be noted that the risk of oral health diseases increases when awareness and oral health measures are ignored. Improper nutritional behavior in students, such as high sugar consumption, not consuming dairy products, and internalizing habits such as reluctance to brush teeth and not using dental floss, can lead to a high incidence of tooth decay [22]. Given the significance of oral health and lifestyle habits in enhancing oral health status, the susceptibility of teenagers to promote health during this pivotal period, the limited indicators of oral health behaviors, and the inadequate examination and care for students’ oral health in Shushtar city, Iran, this study aims to identify the predictors of oral healt (...truncated)