Relationship Between Oral and Hand Hygiene Behaviours Among Brazilian Adolescents: Analysis of the National Adolescent School-Based Health Survey (PeNSE 2019).

objectivesTo investigate the association between daily toothbrushing and hand washing practices among Brazilian adolescent students.

methodsThis cross-sectional study analysed data from the 2019 Brazilian National School-Based Health Survey. The sample comprised 120,054 schoolchildren aged 13-17 who completed an electronic questionnaire at school. The outcome variable was 'low toothbrushing frequency' (< twice/day). The independent variables were hand washing frequency before eating, after using the toilet, and with soap. The covariates were the adolescents' sociodemographic characteristics: sex, age, colour/race and their mother's level of education. Data analysis included Chi-square tests with Rao-Scott correction and logistic regression for complex samples.

resultsAfter adjustments, adolescents who rarely/sometimes and those who never washed their hands before eating were more likely to have a low brushing frequency (< twice/day) than those who most of the time/always washed their hands before eating. Similar results were found for hand washing after using the toilet and for washing with soap.

conclusionsAssociations were found between oral and hand hygiene practices. Regardless of their sociodemographic characteristics, adolescents who reported infrequent hand washing were more likely to brush their teeth less frequently. These findings reinforce the importance of adopting a common risk factors approach to oral and general health in school health programmes.