Aim: To assess the socio-demographic distribution, relationship and levels of health and oral health related knowledge, attitudes and behaviors among secondary school students in Dar-es-Salaam region, Tanzania.

Methods: A cross-sectional survey by means of a self-administered questionnaire to 1934 secondary school students aged 16-20 (mean age 16.9 years). A one stage, proportionate, cluster sampling technique was used, and covered 18 schools from three districts.

Results: Regular tooth brushing was widely practiced by 78.9% of the students. The hygiene behavior levels were low. Hand washing with soap was the least performed hygiene behavior (21.6%) and its performance was greatly influenced by wealth index, gender and parental education. Levels of physical activities were low overall; females had a higher level of physical inactivity as compared to males. Belonging in the wealthiest quartile was associated with higher frequencies of consumption of sugary foodstuffs and fast foods, although having a parent with a high level of education was associated with an increased consumption of fruits and vegetables. Levels of alcohol use were moderately high (25.5%) whereas those of cigarette consumption were low (6.7%). Usage of both substances was more prevalent in male students. Levels of dental attendance were low (19.0%) and were associated with belonging in the wealthiest quartile and having a parent with a high level of education.

Conclusion: A socio-economic and gender vector was apparent and varied greatly in many of the assessed behaviors. Overall levels of students' health and oral health related knowledge and attitudes were good.