# Clustering of Oral Health‐Related Behaviors and Their Association With Sociodemographic Factors in Adolescents Living in England, Wales, and Northern Ireland

## TL;DR

This study found that oral health behaviors like smoking and poor dental habits cluster together in adolescents and are linked to age, gender, and socioeconomic factors.

## Contribution

The study identifies specific behavioral clusters and their sociodemographic associations in adolescents across the UK.

## Key findings

- 15-year-olds had significantly higher odds of smoking and alcohol use clusters compared to 12-year-olds.
- Males were more likely to report lower tooth brushing frequency than females.
- FSM-eligible adolescents were more likely to engage in most risk behaviors except alcohol consumption.

## Abstract

This study investigated the clustering patterns of oral health‐related behaviors and their relationship with sociodemographic factors in a national sample of 12‐ and 15‐year‐olds from England, Wales, and Northern Ireland.

Data from the Child Dental Health Survey (CDHS) 2013 were analyzed. Five individual behaviors were considered: smoking, alcohol use, tooth brushing frequency, sugar intake, and dental attendance. Explanatory variables included sex, age, and eligibility for free school meal (FSM) (as a marker of socioeconomic deprivation). Clustering patterns were assessed using counted clusters, pairwise correlation, and observed/expected ratio analysis. Logistic regression models were performed to assess the associations between behavioral clusters and sociodemographic factors.

The study included 4932 young people, with 51.5% aged 15 years, 50.6% male, and 17.4% eligible for FSM. Statistical differences were found in individual behaviors: Males were more likely to report lower tooth brushing frequency (28.1% vs. 13.6% for females), while 15‐year‐olds were more likely to engage in smoking (28.0% vs. 6.0%) and alcohol consumption (73.5% vs. 29.2%) compared to 12‐year‐olds. FSM‐eligible adolescents were more likely to engage in all risk behaviors, except for alcohol consumption. Seven significant behavioral clusters were identified through O/E analysis, each involving combinations of two or three risk behaviors. In the regression analysis, age was strongly associated with these clusters. For example, 15‐year‐olds had significantly higher odds (OR: 7.04; 95% CI: 4.85–10.22) of exhibiting the cluster involving smoking and alcohol use compared to 12‐year‐olds. Sex and FSM eligibility also showed significant, though weaker, associations with five of the identified behavioral patterns.

Detrimental oral health behavioral clusters were more commonly observed among males, 15‐year‐olds, and adolescents from less advantaged backgrounds.