Demographic and behavioural correlates of toothbrushing practices among schoolchildren in Albania

Objective: Nonadherence to recommended twice daily toothbrushing with a fluoride toothpaste increases the risk of dental caries and periodontal diseases in children. This study aimed at assessing the prevalence and demographic and behavioural correlates of toothbrushing practices among Albanian children. Design and Setting: Cross-sectional study in Albania in 2022. Participants: A nationwide representative sample of 5454 schoolchildren aged 11, 13 and 15 years. Measures: Information on toothbrushing habits, other behavioural factors, and sociodemographic characteristics. Statistical Analysis: Binary logistic regression to assess the association of toothbrushing with demographic characteristics and behavioural factors. Results: Half (56%) of schoolchildren reported brushing their teeth more than once per day (46% in boys vs 66% in girls). Inadequate toothbrushing (≤once/day) was associated with male gender (OR = 2.7, 95% CI = 2.3, 3.0), age 13 (OR = 1.3, 95% CI = 1.1, 1.5), lower family affluence (OR = 1.5, 95% CI = 1.4, 1.8), smoking (OR = 1.4, 95% CI = 1.1, 1.7), inadequate physical exercise (OR = 1.5, 95% CI = 1.3, 1.7), non-daily breakfast consumption (OR = 1.2, 95% CI = 1.1, 1.4), and non-daily fruit consumption (OR = 1.8, 95% CI = 1.6, 2.1). Conclusions: Adequate toothbrushing (at least twice/day) among Albanian children is low compared with most European countries, which should be a cause of serious concern for policymakers and decisionmakers in this post-communist country. There is an urgent need to implement oral health promotion programs in Albania targeting especially boys and children from low socioeconomic families.