Methods: Subjects included a convenience sample of 5138 urban teenagers and 1860 rural teenagers who were enrolled in public middle and high schools in Nevada. Using a cross sectional study design, personnel were trained and calibrated to determine DMF scores and to survey past and current smoking behaviors of the subjects. Due to the nonparametric nature of the data, categorical DMF scores [zero (0), low (1-2), moderate (3-6), and high (7+)] were subjected to a Kruskal-Wallis analysis.
Results: Teenagers that lived in rural areas had significantly different smoking behaviors than those that live in urban areas (F=48.26, p<.001). Bonferonni univariate analysis determined that those in urban environments had higher DMF scores than those in rural areas(F=28.13, p<.001). Those in urban environments were more likely to present with a higher DMF score than those in rural areas. 48% of those in urban locales presented with a DMF score of 3 or greater while only 38% of their rural counterparts figured above this threshold.
Conclusion: There is an inverse relationship between rural and urban locales with respect to DMF scores. Urban teenage smokers accounted for a greater proportion of higher DMF scores than did their rural counterparts. Public health interventions designed to improve oral health status of teens should evaluate the effect of combined smoking prevention and cessation with oral health promotion messages in urban environments. Data for this study were provided by The Fund for A Healthy Nevada Grant.