Toothbrushing behavior in children – an observational study of toothbrushing performance in 12 year olds

Abstract

Background Many countries offer systematic group prevention programs in kindergarten and school in order to promote children’s oral health. Little is known, however, about the actual toothbrushing abilities of children when group prevention programs end. Methods In Germany, all children take advantage from a nationwide group prevention program (called “Gruppenprophylaxe”) lasting from kindergarten up to sixth grade (12 years of age). Standardized recommendations are given concerning brushing systematics and brushing movements. N = 174 children at the age of 12 were thus randomly selected from two German towns and were asked to perform toothbrushing to the best of their abilities in front of a mirror which also served as a camera. Brushing behavior was analyzed by video analysis. Results Children brushed their teeth for an average of 200 s ± 80.48 s (mean ± SD). Still, more than 55% missed at least one sextant when brushing inner surfaces, 16% missed them all. Only 7.5% of the children brushed both inner and outer surfaces by the intended movements (vertical movements on the inner surfaces and circular movements on the outer surfaces) for at least 90% of the respective brushing time. Instead, horizontal brushing was very common on the lateral surfaces. Conclusions The present analysis indicates that children have low efficiency to adopt the tooth-brushing recommendations given in prevention programs. This is surprising as great endeavors are made to help children internalize the recommendations. Future research is needed to better understand which factors impede adoption of toothbrushing recommendations in children and which efforts are necessary to improve their toothbrushing abilities. Electronic supplementary material The online version of this article (10.1186/s12903-019-0755-z) contains supplementary material, which is available to authorized users.

Self-Efficacy, Family Support and Toothbrushing Practice of Primary School Students

“…There is a belief in him that he will be able to complete any difficult action when brushing his teeth, the belief that he is able to complete a variety of clean and healthy behaviors and strive to do so. (7,17,18) This will encourage students to be able to plan brushing his teeth, trying to monitor and manipulating the environment in such a way as to support his brushing activities. Thus it can be seen if the student's self-efficacy is low, it can cause obstacles in the process of brushing his teeth even though the student has great potential.…”

“…(5,17) Social support comes from significant others who are close to (significant others) for students who need help, for example in schools such as teachers and peers. (18,19) The author emphasizes family social support which will influence the daily action of children's toothbrushing.…”

Cleansing efficacy of an auto-cleaning electronic toothbrushing device: a randomized-controlled crossover pilot study

“…In the authors' opinion, the development of auto-cleaning devices seems a gratifying approach to increase both the frequency and the efficacy of toothbrushing which have been ascertained to be insufficient in the majority of adults and adolescents/children [3][4][5][6]19]. Therefore, we undertook analyses to spot the reasons for the lack of efficacy of the amabrush® design.…”

“…Inclusion criteria were (1) age ≥ 14 years, (2) contractual capability, and (3) the presence of ≥ 5 teeth per quadrant. Exclusion criteria were (1) dental or medical students or professionals, (2) oral hygiene instructions prior to the study, (3) community periodontal index of treatment needs (CPITN) grade 3 or 4 [7], (4) pregnancy or breastfeeding, (5) systemic diseases or conditions that are associated with an increased risk of infection or necessitate concomitant antibiotic therapy with dental treatment, and (6) mental and behavioral disorders that impede (verbal) communication. Recruitment was performed from March 15 to April 14, 2019, and data collection was carried out from April 26 to May 13, 2019.…”

“…In 16/20 European countries, 25–50% of teenagers brush their teeth less than twice a day [ 4 ]. Even children trained at school in group prophylaxis programs have low efficiency to adopt the toothbrushing recommendations given: Only 7.5% of the children brushed both inner and outer surfaces by the intended movements for at least 90% of the respective brushing time [ 5 ]. A recent study showed that even after performing oral hygiene to the best of one’s abilities, gingival margins showed persistent plaque at 69.48% ± 12.31% sites (mean ± SD) [ 6 ].…”