title: Socioeconomic inequalities and determinants of oral hygiene status among Urban Indian adolescents.
abstract: OBJECTIVE
  To assess the socioeconomic inequalities in oral hygiene and to explore the role of various socioeconomic and psychosocial factors as determinants of these inequalities among adolescents residing in Delhi National Capital Territory.
  
  
  METHODS
  A cross-sectional study was conducted among 1386 adolescents aged 12-15 years from three different socioeconomic groups according to their area of residence (middle-class areas, resettlement colonies and urban slum colonies). Level of oral hygiene was examined clinically using the Simplified Oral Hygiene Index (OHI-S), and an interviewer-administered questionnaire was used to measure key socio-demographic variables and psychosocial and health-related behaviours. Logistic regression analysis tested the association between area of residence and poor oral hygiene.
  
  
  RESULTS
  Poor oral hygiene was observed in 50.2% of the adolescents. There was a socioeconomic gradient in poor oral hygiene, with higher prevalence observed at each level of deprivation. These differences were only partly explained, and the differences between adolescent groups remained statistically significant after adjusting for various demographic variables, standard of living, social capital, social support and health-affecting behaviours (OR: 1.96, 95% CI: 1.30-2.76; and OR: 2.50, 95% CI: 1.60-3.92 for adolescents from resettlement colonies and urban slums, respectively, than middle-class adolescents).
  
  
  CONCLUSIONS
  Area of residence emerged as a strong socioeconomic predictor of prevalence of poor oral hygiene among Indian adolescents. Various material, psychosocial and behavioural factors did not fully explain the observed inequalities in poor oral hygiene among different adolescent groups.
authors.affiliation: Department of Dental Public Health, Public Health Foundation of India, Gurgaon, Haryana, India.
authors.forename: Manu Raj
authors.initials: MR
authors.lastname: Mathur
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsakos
authors.affiliation: Department of Dental Public Health, Public Health Foundation of India, Gurgaon, Haryana, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Parmar
authors.affiliation: School of Public Health, Imperial College London, London, UK.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Millett
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Watt
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009910:Oral Hygiene / Q000191:economics / Q000706:statistics & numerical data*; D011204:Poverty Areas; D064890:Social Determinants of Health / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014099:Toothbrushing / Q000191:economics / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: adolescents; inequalities; oral health promotion; oral hygiene; psychosocial determinants of oral health