Background
Oral diseases remain a significant public health problem in Nepal, as do oral health behaviours. Socio-demographic factors play a crucial role in driving oral hygiene practices. This study aims to identify oral hygiene practices and associated socio-demographic factors in Nepalese population.

Methods
This descriptive, cross-sectional study recruited 4200 adults (15–69 years) through multistage cluster sampling. Data obtained from the WHO NCD STEPS instrument version 2.2 were analysed in STATA 13.0 using complex sample weighted analysis.

Results
Prevalence of cleaning teeth at least once a day was 94.9 % (95 % CI: 93.7–95.9), while that of cleaning teeth at least twice a day was 9.9 % (95 % CI: 8.2–11.9). Use of fluoridated toothpaste was seen among 71.4 % (95 % CI: 67.9–74.7) respondents. A 3.9 % (95 % CI: 3.1–5.0) made a dental visit in the last 6 months.

The 45–69 years age group had lesser odds of cleaning teeth at least once a day (AOR: 0.4; 95 % CI: 0.2–0.8), in comparison to 15–29 years age group. Women had greater odds of cleaning teeth at least twice a day (AOR: 1.7; 95 % CI: 1.1–2.4) and having visited a dentist in the last 6 months (AOR: 2.2; 95 % CI: 1.2–3.8) compared to men. With reference to rural residents, urban population had higher odds of using fluoridated toothpaste (AOR: 2.3; 95 % CI: 1.4–3.4) and making a dental visit within the last 6 months (AOR: 1.9; 95 % CI:1.1–3.6). Inhabitants of the Terai had five-fold (AOR: 4.9; 95 % CI: 3.1–7.8) greater odds of cleaning teeth once per day than did hill residents. Those with higher education had greater odds than non-formal education holders of cleaning teeth at least once a day (AOR: 9.0; 95 % CI: 2.9–27.7), cleaning teeth at least twice a day (AOR: 5.6; 95 % CI: 2.9–10.6), using fluoridated toothpaste (AOR: 13.9; 95 % CI: 8.4–23.1), and having visited a dentist in the last 6 months (AOR: 2.8; 95 % CI: 1.4–5.4).

Conclusions
Cleaning teeth at least once a day is widely prevalent in Nepal and a substantial number of population use fluoridated toothpaste. However, cleaning teeth twice a day and visiting a dentist is less common. Being women, Terai residents, urban residents, and educated were significantly associated with oral hygiene practices assessed in this study.