title: Geographic and socioeconomic variations in adolescent toothbrushing: a multilevel cross-sectional study of 15 year olds in Scotland.
abstract: BACKGROUND
  This study examined urban-rural and socioeconomic differences in adolescent toothbrushing.
  
  
  METHODS
  The data were modelled using logistic multilevel modelling and the Markov Chain Monte Carlo method of estimation. Twice-a-day toothbrushing was regressed upon age, family affluence, family structure, school type, area-level deprivation and rurality, for boys and girls separately.
  
  
  RESULTS
  Boys' toothbrushing was associated with area-level deprivation but not rurality. Variance at the school level remained significant in the final model for boys' toothbrushing. The association between toothbrushing and area-level deprivation was particularly strong for girls, after adjustment for individuals' family affluence and type of school attended. Rurality too was independently significant with lower odds of brushing teeth in accessible rural areas.
  
  
  CONCLUSIONS
  The findings are at odds with the results of a previous study which showed lower caries prevalence among children living in rural Scotland. A further study concluded that adolescents have a better diet in rural Scotland. In total, these studies highlight the need for an examination into the relative importance of diet and oral health on caries, as increases are observed in population obesity and consumption of sugars.
authors.affiliation: NHSGGC, Public Health Directorate, Gartnavel Royal Hospital, 1055 Great Western Road, G12 0HX, UK Ludwig Boltzmann Institute, Untere Donaustraße 47, 3rd Floor, Vienna A-1020, Austria.
authors.forename: K A
authors.initials: KA
authors.lastname: Levin
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow G2 3QB, UK.
authors.forename: N
authors.initials: N
authors.lastname: Nicholls
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow G2 3QB, UK.
authors.forename: S
authors.initials: S
authors.lastname: Macdonald
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow G2 3QB, UK.
authors.forename: R
authors.initials: R
authors.lastname: Dundas
authors.affiliation: Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK.
authors.forename: G V A
authors.initials: GV
authors.lastname: Douglas
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data*; D012606:Scotland; D012737:Sex Factors; D012959:Socioeconomic Factors; D014099:Toothbrushing / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: adolescent; toothbrushing; urban–rural