Hye-Sun Shin, Dong-Hun Han
These findings highlight a gap in public health as infection prevention focused on handwashing while largely neglecting oral health education, which may leave lasting effects on adolescent oral health. Future pandemic strategies should integrate oral health education into hygiene programs to preserve essential long-term health behaviours.
AIM: This study analysed changes in handwashing and toothbrushing behaviours among South Korean adolescents before, during, and after the COVID-19 pandemic, and evaluated the effects of personal hygiene education on these behaviours and oral health.
METHODS: We analysed nationally representative data from the Korea Youth Risk Behaviour Web-based Survey (2018-2024), including 385,484 adolescents aged 12 to 18. The study period was divided into pre-pandemic (2018-2019), intra-pandemic (2020-2022) and post-pandemic (2023-2024). Multivariable logistic regression assessed the effects of school-based hygiene education on handwashing and toothbrushing after lunch and the association between toothbrushing and gingival bleeding, stratified by socioeconomic status and city type.
RESULTS: Handwashing compliance increased from 44.1% pre-pandemic to 55.0% during the pandemic, then declined to 45.5% post-pandemic, whereas toothbrushing fell from 39.0% to 24.4% during the pandemic, with partial recovery to 29.0% post-pandemic. School-based hygiene education was consistently associated with increased handwashing across all city types and income levels, with the strongest effects during the pandemic. Its effect on toothbrushing was significant only during the pandemic and weakened post-pandemic, especially in small/medium cities and middle-income adolescents. Toothbrushing was inversely associated with gingival bleeding, particularly among metropolitan and high-income adolescents, but this protective effect decreased post-pandemic.
CONCLUSION: These findings highlight a gap in public health as infection prevention focused on handwashing while largely neglecting oral health education, which may leave lasting effects on adolescent oral health. Future pandemic strategies should integrate oral health education into hygiene programs to preserve essential long-term health behaviours.