Social determinants and behavioural factors influencing toothbrushing frequency among primary school children in rural Australian community of Lithgow, New South Wales

Polish pregnant women's knowledge on early childhood caries prevention and oral hygiene in children

BACKGROUND

Early childhood caries (ECC) is one of the most common chronic diseases among children. In Poland 86.9% of six-year-olds have ECC. One of the factors determining adherence to ECC prophylaxis and oral hygiene is mothers' knowledge. The aim of this study was to assess the level of knowledge demonstrated by pregnant women about ECC prevention and oral hygiene, and to analyse the determinants of this knowledge.

METHODS

A quantitative survey was conducted using Computer Assisted Telephone Interview technique on a randomly selected representative sample of 1,000 women over the age of 18 in their second and third trimesters of pregnancy. The significance level was established at 0.05 and p-values were presented as: p < 0.05, p < 0.01 and p < 0.001.

RESULTS

The highest percentage of wrong or "I don't know" answers were related to questions about: the number of free dental check-ups for children (76.8%), the date of the child's first visit to the dentist (66.5%), the age when the child has mixed dentition (72.2%). Women with higher education had better knowledge than women with lower or secondary education. Women with good and very good financial situation showed a higher level of knowledge compared to women with average, bad and very bad financial situation.

CONCLUSIONS

When developing prevention strategies and educational programs as part of prenatal care for women to reduce the incidence of ECC, it is important to take into account the identified areas that need support and specific target groups (mothers with lower socioeconomic status).

Adolescent Toothbrushing and Its Association with Sociodemographic Factors-Time Trends from 1994 to 2018 in Twenty Countries

Regular toothbrushing is the primary self-care method to prevent the most common dental diseases and is considered an important public health indicator. This retrospective observational study aimed to examine cross-national time trends in adolescent toothbrushing behaviour and its association with sociodemographic factors between 1994 and 2018. We studied data from 20 countries that conducted seven surveys of the Health Behaviour in School-aged Children (HBSC) study. Adolescents aged 11, 13 and 15 years responded to questions on their toothbrushing frequency, family affluence and structure. Altogether, reports of 691,559 students were analysed using descriptive statistics and binominal logistic regression. The findings showed an overall positive trend in the prevalence of more-than-once-a-day toothbrushing frequency during the entire study period mainly due to a noticeable increase from 1994 to 2010 (except Denmark and Sweden); this trend continued significantly thereafter in 12 of 20 countries. Across all countries, girls and adolescents from more affluent families were more likely to brush their teeth regularly. These relationships remained unchanged throughout the study period, whereas the age-related difference in toothbrushing prevalence decreased noticeably, and the negative relationship between toothbrushing and living in a non-intact family became evident. While the prevalence of regular toothbrushing among adolescents has increased in recent decades, it is still far behind the recommended level of twice-daily brushing for everyone across all countries. The promotion of toothbrushing needs to start at an early age, with a special focus on boys and adolescents from low-affluence and non-intact families.

Factors predicting different times for brushing teeth during the day: multilevel analyses

BACKGROUND

The most effective and simple intervention for preventing oral disease is toothbrushing. However, there is substantial variation in the timing of brushing teeth during the day. We aimed to identify a comprehensive set of predictors of toothbrushing after lunch and after dinner and estimated contextual (i.e., geographic) variation in brushing behavior at different times of the day.

METHODS

We constructed a conceptual framework for toothbrushing by reviewing health behavior models. The main data source was the 2017 Community Health Survey. We performed a four-level random intercept logistic regression to predict toothbrushing behavior. (individual, household, Gi/Gun/Gu, and Si/Do).

RESULTS

Individuals under 30 years of age had higher likelihood of brushing after lunch, while brushing after dinner was higher among those aged 40-79 years. People engaged in service/sales, agriculture/fishing/labor/mechanics, as well as student/housewife/unemployed were 0.60, 0.41, and 0.49 times less likely to brush their teeth after lunch, respectively, compared to those working in the office, but the gap narrowed to 0.97, 0.96, 0.94 for brushing after dinner. We also found significant area-level variations in the timing of brushing.

CONCLUSIONS

Different patterns in association with various factors at individual-, household- and Si/Gun/Gu-levels with toothbrushing after lunch versus toothbrushing after dinner suggests a need for tailored interventions to improve toothbrushing behavior depending on the time of day.

Socioeconomic Status and Toothbrushing in Indigenous and Non-Indigenous Australian Children

INTRODUCTION

Dental caries in children is a multifactorial and complex condition. Toothbrushing helps maintain good oral hygiene and delivers fluoride. However, determinants of toothbrushing could vary based on Indigenous status.

OBJECTIVE

This study aimed to assess the association between socioeconomic status and adequate toothbrushing practice (brushing twice or more a day) in Indigenous and non-Indigenous Australian children.

METHODS

Data were acquired from the National Child Oral Health Survey (NCOHS) 2012 to 2014. NCOHS administered questionnaires to parents of a representative sample of 24,215 Australian children aged 5 to 14 y recruited using a complex sampling method. Data on the frequency of toothbrushing and socioeconomic status were collected through the questionnaires. Statistical analysis was conducted progressively from bivariate to multivariable regression modeling, stratified by Indigenous status.

RESULTS

Just over half of Indigenous children and over two-thirds of non-Indigenous children reported adequate toothbrushing. The prevalence of adequate brushing (twice or more a day) was 42% (95% confidence interval [CI], 1.10-1.84) higher among children with an overseas-born parent than those with Australian-born parents. Among non-Indigenous children, sex and age, parents' country of birth, number of children in the family, and other family socioeconomic indicators (education, income, private health insurance) were associated with adequate toothbrushing. The prevalence of adequate brushing was 1.09 (95% CI, 1.03-1.15) and 1.15 (95% CI, 1.10-1.21) times higher when their parent possessed vocational training and tertiary education, respectively, compared to those children whose parents had school-level education.

CONCLUSIONS

There were differences in patterns of socioeconomic disparities for toothbrushing practices between Indigenous and non-Indigenous Australian children.

KNOWLEDGE TRANSFER STATEMENT

To promote positive toothbrushing practices in children, dental clinicians and public health professionals must be aware of the determinants of toothbrushing practices. Socioeconomic disparities in toothbrushing frequency were more apparent in non-Indigenous children. These results will help develop population-specific interventions that tackle the determinants to help improve oral hygiene behavior in Indigenous and non-Indigenous children.

Awareness of professional fluoride application and its caries prevention role among women in KSA

Objectives

Considering the high caries prevalence among Saudi females, spreading knowledge on caries prevention modalities such as high-concentration professional fluoride (PF) applications could decrease their risk of dental caries. However, little is known about the current level of female awareness on the important caries prevention role of PF applications. Therefore, this study assessed the level of awareness of female adults in the KSA regarding PF application and its role in caries prevention.

Methods

An electronic self-administered anonymous questionnaire was distributed among women in Almadinah Almunawwarah, KSA using social media groups. It consisted of four sections: demographic data, caries experience, knowledge regarding fluoride and caries prevention, and knowledge regarding PF application and caries prevention. For the statistical analyses, simple descriptive statistics as means and frequency distributions were calculated, whereas comparisons were performed using the chi-squared test.

Results

A total of 405 females participated in the study. Participants were mostly married non-working Saudi women aged between 18 and 55 years. The education level of the majority of participants was at least a bachelor's degree. Most of the participants reported a high caries experience indicated by the presence of cavities (69.1%), fillings (87.2%), and missing teeth due to cavities (64.7%). Regarding PF questions, 34.8% knew the role of PF in caries prevention and 35.6% responded correctly to forms of PF. Only 14.5% reported receiving PF, whereas 57.3% did not know the frequency of PF application. A significant relationship was found between a lack of knowledge regarding the role of PF application and the presence of cavities (p = 0.003). Only 30.4% of participants reported receiving advice from their dentists regarding PF application.

Conclusion

Most female adults in Almadinah Almunawwarah, KSA have limited knowledge of the importance of PF application in caries prevention, which could contribute to their caries experience.

Child- and family-level factors associated with toothbrushing frequency in a sample of Australian children

BACKGROUND

Identifying the factors that are conducive to good toothbrushing practices is fundamental for planning oral health promotion interventions.

AIM

This study evaluated the relationships between child and family socio-demographic characteristics; children's behaviour during toothbrushing; family support for toothbrushing; parents' practices, attitudes and knowledge related to toothbrushing; general parenting practices; and children's behavioural problems, and children's toothbrushing frequency.

DESIGN

A cross-sectional survey was conducted between February and May 2020 with parents of children aged 2-8 years, recruited through childcare centres throughout Australia. Parents completed self-administered surveys on child and family characteristics.

RESULTS

A total of 606 parents completed the survey. Only half (52.5%) of the children of surveyed parents brushed their teeth twice or more/day. Children of university-educated parents [odds ratio (OR): 6.48; 95% confidence intervals (CIs): 1.21-34.71] and those concerned about their child's toothbrushing (OR: 1.44; 95% CI: 1.21-1.72) were more likely to brush twice or more/day. Where children were non-compliant during toothbrushing or parents reported using ineffective parenting strategies during toothbrushing, children were less likely to brush their teeth twice or more/day. Lack of concern of parent about toothbrushing was associated with brushing less than twice/day in children CONCLUSIONS: Measures of parenting and child behaviour that were specific to the toothbrushing context were associated with twice daily brushing while general measures of parenting and child behaviour were not correlated with twice daily brushing.

Socioeconomic Inequalities and Toothbrushing Frequency among Schoolchildren Aged 6 to 12 Years in a Multi-Site Study of Mexican Cities: A Cross-Sectional Study

Periodic toothbrushing is the most common, effective, and reliable way to mechanically remove biofilm from oral tissues. The objective of the present study was to determine the association between toothbrushing frequency and socioeconomic position for schoolchildren between 6 and 12 years of age in four cities in Mexico. A cross-sectional study was conducted on 500 Mexican schoolchildren between 6 and 12 years of age from public schools in four Mexican cities. Questionnaires were administered to the parents/guardians of the schoolchildren to obtain the variables included in the study. The dependent variable was toothbrushing frequency, dichotomized as: 0 = less than twice a day and 1 = at least twice a day. The analysis was performed in Stata. The average age of the schoolchildren was 8.9 ± 1.9 years; 50.4% were female. The prevalence of toothbrushing was 52.8% (at least twice a day) (95% CI = 48.4−57.1). In the multivariate model, the variables associated (p < 0.05) with toothbrushing frequency were older age of the schoolchild (OR = 1.14); younger age of the mother (OR = 0.93); being a girl (OR = 1.70); being enrolled in Seguro Popular (OR = 0.69); being in a household that was owned (OR = 2.43); and being a schoolchild who lived in a home that owned a car (OR = 1.31). The prevalence of toothbrushing at least twice a day was just over 50% in these Mexican children. We found demographic and socioeconomic variables to be associated with toothbrushing. Based on socioeconomic variables that were associated with toothbrushing frequency—such as health insurance, home ownership and the household owning a car—the results of the present study confirm the existence of health inequalities in toothbrushing frequency.

The influence of family socioeconomic status on toothbrushing practices in Australian children

OBJECTIVE

To assess the relationship between toothbrushing behavior and socio-demographic characteristics in Australian children.

METHODS

Data were collected through the 2012-2014 Australian National Child Oral Health Survey (NCOHS). NCOHS was a cross-sectional survey of representative school children aged 5-14 years of Australia with a total sample size of 24,664 children.

RESULTS

Two-thirds (69%) of Australian children brushed twice or more times a day and the mean age of starting toothbrushing with fluoridated toothpaste was 24 months. Males were less consistent with toothbrushing than females (OR = 0.85; 95% CI: 0.74-0.97) and the likelihood of brushing twice or more a day improved with the increase in age (OR = 1.05; 95% CI: 1.02-1.08). Children with university educated (OR = 1.80; 95% CI: 1.44-2.26), vocational trained parents'/guardians' (OR = 1.45, 95% CI 1.11-1.90), living in families with an income of >AU$120,000 (OR = 1.42; 95% CI: 1.08-1.89) and having an overseas born parent (OR = 1.30; 95% CI: 1.07-1.58) were more likely to brush their teeth twice or more a day than their comparative counterparts. Children in households with two children (OR = 1.33; 95% CI: 1.07-1.64) were more likely to brush twice or more than single-child households. Children with a health welfare card tended to delay the start of toothbrushing by 1.4 months in comparison to those without a welfare card. Children with one of the caregivers born overseas started brushing later than those with Australia born caregivers (B = 1.04; SE = 0.46). Children living in high income and educated families and households with two or more children tended to start toothbrushing at an earlier age.

CONCLUSIONS

Several family socio-demographic factors influenced toothbrushing habits in Australian children.

Oral Health Behaviour of Nine-Year-Old Children and Their Parents in Sarajevo

The oral health situation in Bosnia and Herzegovina is among the worst in Europe. We investigated the oral health behaviour of primary schoolchildren and their parents in Sarajevo. This was an anonymous cross-sectional survey among third-grade schoolchildren and their parents’ oral health habits in Canton Sarajevo. Cluster random sampling yielded a representative sample from all the public schools in Canton Sarajevo in 2019. The survey targeted a total of 441 children and 365 parents. Two thirds (66.5%) of the children reported brushing their teeth twice daily, and almost half of them failed to use fluoride toothpaste daily. Girls brushed their teeth significantly more often than did the boys (74% vs. 58%, p = 0.004). Children living in residential areas of middle and high socioeconomic status (SES) reported better oral health habits than did those living in areas of low SES. Our study showed that Sarajevo children’s oral health habits were poor. One-third of the nine-year-olds failed to brush their teeth according to recommendations, and almost half of them failed to use fluoride toothpaste daily. Improving the children’s oral health in the future will urgently require national oral health promotion and prevention programmes.