{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:05Z","timestamp":1789020425248,"version":"build-2803163510"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral and hand hygiene constitute fundamental determinants of adolescent health. However, globally comparable estimates of these behaviours remain limited. We aimed to estimate the prevalence of toothbrushing and handwashing practices among adolescents aged 12\u201317\u202fyears and to quantify disparities by sex, age, geographical region, and national income level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used nationally representative data from the Global School-based Student Health Survey (GSHS) collected between 2010 and 2019, covering 244,040 adolescents from 72 countries. Toothbrushing frequency was categorised as &amp;lt;1 time\/day, 1 time\/day, and \u22652 times\/day. Hand hygiene was assessed via three items: never or rarely washing hands before eating, after using the toilet, and using soap. The overall, subgroup-specific, and country-specific prevalence estimates were calculated accounting for primary sampling units, strata, and sampling weights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall prevalence of brushing teeth &amp;lt;1 time\/day was 10.9% (95%CI\u202f=\u202f10.0\u201311.8), ranging from 2.6% in Benin to 35.2% in Yemen. Brushing \u22652 times\/day was reported by 70.5% (68.8\u201372.0). Never or rarely washing hands before eating, after toilet use, and using soap were reported by 6.5% (6.1\u20137.0), 5.5% (5.1\u20135.9), and 9.0% (8.5\u20139.5), respectively. Boys exhibited inferior hygiene practices relative to girls (for instance, brushing &amp;lt;1 time\/day: 13.1% vs. 8.6%; never\/rarely using soap: 10.4% vs. 7.6%). Younger adolescents (12\u201314\u202fyears) showed a higher prevalence of inadequate brushing (12.2% vs. 9.4%) but marginally better handwashing before eating than older adolescents (15\u201317\u202fyears). The Eastern Mediterranean Region displayed the highest prevalence of inadequate brushing (30.7%), whereas the Region of the Americas showed the lowest (5.3%). A marked economic gradient was observed for toothbrushing (inadequate brushing declined from 12.5% in the poorest quintile to 4.4% in the richest), but hand hygiene showed no monotonic income gradient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inadequate oral and hand hygiene practices remain prevalent among adolescents globally, with substantial heterogeneity by sex, age, region, and national income. Targeted school-based interventions, particularly for boys and in low-income and Eastern Mediterranean countries, are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1939346","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:33:15Z","timestamp":1789018395000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral and hand hygiene practices among adolescents aged 12\u201317\u202fyears in 72 countries: a cross-sectional study using global school-based student health survey data (2010\u20132019)"],"prefix":"10.3389","volume":"14","author":[{"given":"Zongwei","family":"Huang","sequence":"first","affiliation":[{"name":"Beijing University of Chinese Medicine Shenzhen Hospital (Longgang)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingru","family":"Lin","sequence":"additional","affiliation":[{"name":"Beijing University of Chinese Medicine Shenzhen Hospital (Longgang)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref1","first-page":"362","article-title":"Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study","volume-title":"J Dent Res","author":"Bernabe","year":"2017"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: a global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"ref3","volume-title":"Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1111\/tmi.12339","article-title":"Hygiene and health: systematic review of handwashing practices worldwide and update of health effects","volume":"19","author":"Freeman","year":"2014","journal-title":"Trop Med Int Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.2105\/AJPH.2007.124610","article-title":"Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis","volume":"98","author":"Aiello","year":"2008","journal-title":"Am J Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/S1473-3099(03)00606-6","article-title":"Effect of washing hands with soap on diarrhoea risk in the community: a systematic review","volume":"3","author":"Curtis","year":"2003","journal-title":"Lancet Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1016\/S0140-6736(12)60072-5","article-title":"Adolescence: a foundation for future health","volume":"379","author":"Sawyer","year":"2012","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1111\/idj.12094","article-title":"Oral hygiene practices among middle-school students in 44 low- and middle-income countries","volume":"64","author":"McKittrick","year":"2014","journal-title":"Int Dent J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"495","DOI":"10.17219\/dmp\/185842","article-title":"Toothbrushing frequency among children and adolescents in 72 countries: findings from the global school-based student health survey","volume":"61","author":"Das Gupta","year":"2024","journal-title":"Dent Med Probl"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4984","DOI":"10.3390\/ijerph18094984","article-title":"Global variation in hand hygiene practices among adolescents: the role of family and school-level factors","volume":"18","author":"Jatrana","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e0275111","DOI":"10.1371\/journal.pone.0275111","article-title":"Affordability of essential medicines: the case of fluoride toothpaste in 78 countries","volume":"17","author":"Gkekas","year":"2022","journal-title":"PLoS One"},{"key":"ref12","volume-title":"Global School-based Student Health Survey (GSHS). 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