title: Smoking, tooth brushing and oral cleanliness among 15-year-olds in Tehran, Iran.
abstract: OBJECTIVE
  To assess smoking, tooth brushing and oral cleanliness and their relationships among 15-year-olds in Tehran, Iran.
  
  
  METHODS
  A cross-sectional study based on World Health Organization criteria and the methods of the Second International Collaborative Study was carried out in autumn 2004 among 15-year-olds (n=502) in Tehran. Data were based on a self-administered questionnaire and a clinical dental examination.
  
  
  RESULTS
  Smokers comprised 5% of the boys and 2% of the girls (p = 0.02). Smoking was more common among students of less-educated parents (50% vs. 30%, p < 0.05). Of all students, 26% reported twice-daily tooth brushing; those of higher socio-economic backgrounds and girls did so more frequently. Of the smokers, 11% reported no tooth brushing compared to 6% of the non-smokers. Oral cleanliness was good for 13%, moderate for 32%, and poor for 55%; the rates associated positively with female gender (p = 0.002), having higher-educated parents (p = 0.03), and reporting a higher frequency of tooth brushing (p < 0.001). Those students reporting twice-daily tooth brushing had less dental plaque and gingival bleeding (p < or = 0.01) on both anterior and posterior teeth. In multivariable analyses, the best predictors for a good level of oral cleanliness were female gender (OR = 2.0) or twice-daily tooth brushing (OR = 1.7).
  
  
  CONCLUSIONS
  Oral cleanliness and tooth brushing among 15-year-olds were at poor levels, particularly among boys. Such poor levels call for intensive attempts to enhance rates of twice-daily tooth brushing and to improve its quality. For this age group, anti-smoking purposes should be combined into school-based oral health promotion programmes as well.
authors.affiliation: Institute of Dentistry, University of Helsinki, Helsinki, Finland. Reza.Yazdani@helsinki.fi
authors.forename: Reza
authors.initials: R
authors.lastname: Yazdani
authors.forename: Miira M
authors.initials: MM
authors.lastname: Vehkalahti
authors.forename: Mahtab
authors.initials: M
authors.lastname: Nouri
authors.forename: Heikki
authors.initials: H
authors.lastname: Murtomaa
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D003945:Diagnosis, Oral; D005260:Female; D015438:Health Behavior; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D009910:Oral Hygiene / Q000523:psychology*; D010512:Periodontal Index; D012737:Sex Factors; D012907:Smoking / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000523:psychology