Principal motives for toothbrushing in a population of South African adolescents: implications for oral health promotion.

Little is known of the motives for tooth-brushing among adolescents in resource-poor settings. To investigate the principal motive for tooth-brushing among a rural population of South African adolescents. The participants were high school students between the ages of 12 and 19 years who provided baseline data during 2005 as part of a tobacco use prevention trial (n = 2119). Information was obtained using a self-administered survey questionnaire, including demographic data, data on the employment status of the parents, oral health practices and risk behaviors. The main outcome measure was the principal reason for brushing. Data was analyzed using chi-square statistics and multiple logistic regression analysis. Of the study participants, only 27.2% had ever visited a dentist. For 28.9%, both parents are unemployed. The principal motive for brushing among most adolescents (84.9%), including those who reported frequent sugar intake, was related to cosmetic rather than preventive dental health reasons. Motives for brushing were not associated with brushing frequency. However, the socially disadvantaged, current smokers, and those who reported a past suicide attempt were significantly less likely to brush for cosmetic reasons. Motives for tooth-brushing among adolescents may reflect their psychosocial state rather than knowledge of the preventive effect of brushing.