title: Trends in toothbrushing in 20 countries/regions from 1994 to 2010.
abstract: BACKGROUND
  For maintaining good oral health, twice-a-day toothbrushing routine is recommended world-wide. As an association between oral diseases and the main non-communicable diseases is confirmed, the importance of brushing is rising. The aim of this article is to describe trends in more-than-once-a-day toothbrushing frequency in 20 countries/regions participating in five consecutive HBSC Surveys between 1994 and 2010.
  
  
  METHODS
  Eleven-, 13-, and 15-year-old children, who replied to the questionnaire in any of the five surveys, were included (N = 474 760). Trends were analysed by logistic regression and multilevel logistic regression modelling.
  
  
  RESULTS
  Prevalence of recommended toothbrushing behaviour increased in all countries except in Scandinavia, which had already attained a very high level in 1994. The highest increase (more than + 16%) was observed in Estonia, Russia, Latvia, Finland and in Flemish Belgium. Girls had higher prevalence of toothbrushing than boys (OR = 2.06, 99% CI 2.03-2.10). However, the increasing trend was stronger among boys (OR(2010 vs. 1994) for boys 1.60; for girls 1.48), and among the younger adolescents (OR(2010 vs. 1994) for 11-year-olds 1.64; for 15-year-olds 1.45).
  
  
  CONCLUSIONS
  Recommended toothbrushing frequency increased in most of the studied countries/regions and differences between the countries diminished during 2004-2010.
authors: 1 Department of Developmental & Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait 2 Department of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland sisko.l.honkala@gmail.com.
authors: Sisko
authors: S
authors: Honkala
authors: 3 Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium 4 Research Foundation- Flanders (FWO), Brussels, Belgium.
authors: Carine
authors: C
authors: Vereecken
authors: 5 National Institute of Public Health, Copenhagen, Denmark.
authors: Birgit
authors: B
authors: Niclasen
authors: 1 Department of Developmental & Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait 2 Department of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
authors: Eino
authors: E
authors: Honkala
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000639:trends*