Eating habits, smoking and toothbrushing in relation to dental caries: a 3-year study in Swedish female teenagers.

OBJECTIVES The aims of the present study were to describe eating, toothbrushing and smoking habits in a cohort of Swedish female adolescents, and to relate the findings to dental caries increment. DESIGN The research took the form of a longitudinal study. SUBJECTS AND METHODS The study sample consisted of a cohort of 162 girls under regular dental care, aged 12 years at baseline, who were followed for 3 years, from the sixth to the ninth grade. Eating, oral cleaning and smoking habits were self-reported three times per year through a questionnaire, and caries data at baseline and after 3 years were collected from dental records. RESULTS The results showed significantly (P < 0.05) impaired eating habits during the study period and that adherence to regular main meals diminished. In the eighth grade, one-third of the girls skipped breakfast before school and only 50% had their free school lunch daily. The omission of breakfast and irregular main meals, as well as smoking were significantly associated with caries (decayed, missed and filled surfaces) increment in the eighth grade (odds ratio = 4.1-4.9, P < 0.05). Snacks, light meals, soft drinks and sweets were already frequently consumed at baseline and continued to be so over the years. Although > 95% of subjects reported that they brushed their teeth at least once a day, approximately 20% did not do it every evening, and this figure remained stable over the study period. However, snacks, soft drinks and sweets, and toothbrushing habits had no significant influence on caries development. CONCLUSION Dietary advice for caries prevention in adolescent girls should focus on the importance of retaining regular main meals, and especially, not skipping breakfast.