Factors Influencing Adolescents' Knowledge, Practices, and Attitudes Towards Oral Health in the Rupa-Rupa District, Peru.

Abstract

Aim: This study aimed to identify factors associated with adolescents' knowledge, practices, and attitudes (KPA-OH) regarding oral health in the Rupa-Rupa district, a high jungle region of Peru.

Materials and methods: An analytical study was conducted with a sample of 408 adolescents (aged 13-17 years) from seven public schools in the Rupa-Rupa district (elevation: 649 meters above sea level). The sample was stratified by sex, age, and school. Data were collected using a 49-item questionnaire, which included sections on knowledge (10 items), practices (10 items), and attitudes (13 items) toward oral health, as well as 16 sociodemographic variables. The reliability of the questionnaire was confirmed (KMO ≥ 0.537, Bartlett's test: P < 0.001, ω ≥ 0.7). Multiple linear regression models were used to analyze associations, with significance set at P < 0.05, using Jamovi software.

Results: Correct knowledge regarding oral health was highest for understanding the functions of teeth (speech, chewing), the link between caries and bacteria-sugar interaction, the relationship between gingivitis and gum inflammation, fluoride as a remineralizing agent, and the use of dental floss for cleanliness (73.3%-99.8%). Appropriate oral health practices, such as using an individual toothbrush, replacing it quarterly, and brushing twice a day for 2 minutes (89.8%-99.8%), were associated with being the only child and not having reading difficulties (P ≤ 0.03). Positive attitudes toward brushing and dental visits for caries and gingivitis prevention were more prevalent in females (P < 0.001). Multiple regression analyses revealed that demographic factors explained 21.4% of the variance in oral health knowledge (F = 2.05, P < 0.001), but had no significant predictive value for oral health practices (P = 0.127) or attitudes (P = 0.230). Significant predictors of better knowledge included being female (β = 0.3257, P = 0.026), aged 15-17 years (β = 0.6477-0.8246, P ≤ 0.006), and having part-time employed parents (β = 0.5097, P = 0.007). Negative associations with knowledge were observed in adolescents with reading difficulties (β = -0.6376, P = 0.018) and comorbidities (β = -0.5405, P = 0.031).

Conclusion: Factors such as sex, age, sibling position, general health, reading abilities, and parental employment status were found to influence adolescents' oral health knowledge, practices, and attitudes. Clinically, these findings suggest that targeted oral health education programs should consider these demographic factors, especially for adolescents with reading difficulties and comorbidities, to improve oral health outcomes in underserved populations. The results also highlight the need for interventions that emphasize preventive oral health practices, particularly among younger adolescents and those from lower socioeconomic backgrounds.