Social inequalities in clustering of oral health related behaviors in a national sample of British adults

•We assessed clustering of oral health related behaviors in British adults.•Oral health compromising behaviors tend to cluster with each other and they do not occur in isolation.•A very clear educational gradient was observed in clustering of behaviors.•We recommend health promotion strategies to address the common risk factors in tackling multiple clustering of behaviors.

Objectives1.To assess clustering of oral health related behaviors among a sample of British adults.2.To determine the variation in clustering of oral health related behaviors by socioeconomic position.MethodWe used secondary analysis of the Adult Dental Health Survey 2009 data. Health behaviors referred to smoking, tooth brushing frequency, dental visits and sugar consumption. Clustering was assessed by pairwise correlations, counts of clustering of health compromising behaviors and comparison of observed/expected ratios. Logistic regression was used to assess variation in clustering of oral health related behaviors by socioeconomic position crudely and adjusted for age, gender and self-rated oral health.ResultsThere were weak correlations between four health behaviors. Very low prevalence of clustering was reported. Higher observed to expected ratio was observed for clustering patterns with lower prevalence. Multivariate logistic regression showed clear, strong and significant educational gradients in associations between different clustering patterns of health compromising behaviors and educational attainment. These educational gradients remained significant after adjusting for age, gender and self-reported oral health.ConclusionVery clear and strong educational gradients were observed throughout patterns of clustering of oral health compromising behaviors, suggesting chances of having detrimental behavioral clustering are lower in more educated groups in population.