Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey

doi:10.1186/s12903-023-02746-0

. 2023 Jan 30;23(1):50.

doi: 10.1186/s12903-023-02746-0.

Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey

Heba Mohamed Elkhodary^{1

2}, Mohamed Hussein Abdelnabi^{3

4}, Amal Ali Swelem⁵, Heba Jafar Sabbagh¹, Omar Abd El Sadek El Meligy^{1

6}, Iman Mamdouh Talaat^{7

8}, Enas B Abdellatif⁶, Yousef Khader⁹, Ola B Al-Batayneh¹⁰, Nuraldeen Maher Al-Khanati¹¹, Nazik M Nurelhuda¹², Sara Alhabli¹, Mohamed Hassan Mostafa², Shabnum Qureshi¹³, Nafeesa Qureshi¹⁴, Muhammad Abrar Yousaf¹⁵, Dunia Taha¹⁶, Yousef Falah Marafi¹⁷, Sharifa Nasser Al Harrasi¹⁸, Sarah Al-Rai¹⁹, Noha Gomaa^{20

21}, Hala Mattar¹⁷, Hanin A Bakhaider¹, Bahia Samodien²², Hanane Lố²³, Maha El Tantawi²⁴

Affiliations

¹ Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
² Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt.
³ Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Department of Removable Prosthodontics, Faculty of Dentistry, Minia University, Minia, Egypt.
⁵ Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt.
⁶ Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
⁷ Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE.
⁸ Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
⁹ Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
¹⁰ Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
¹¹ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria.
¹² Dental Public Health Division, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
¹³ Department of Education, University of Kashmir, Srinagar, India.
¹⁴ NHS Tayside Scotland, Dundee, DD2 2RZ, UK.
¹⁵ Department of Biology, Faculty of Science and Technology, Virtual University of Pakistan, Lahore, Pakistan.
¹⁶ Department of Pediatric Dentistry, Faculty of Dental Medicine, Damascus University, Damascus, Syria.
¹⁷ Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
¹⁸ Department of Pediatric, Kids Paradise Dental Center, Seeb, Sultanate of Oman.
¹⁹ Department of Conservative and Preventive Dentistry, Faculty of Dentistry, Saba University, Sana'a, Yemen.
²⁰ Oral Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
²¹ Department of Oral Medicine, Children's Health Research Institute, London, ON, Canada.
²² Western Cape Education Department, Cape Town, South Africa.
²³ Department of Pediatric Dentistry, Clinique Dentaire D'Agadir, Agadir, Morocco.
²⁴ Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt. maha.tantawy@alexu.edu.eg.

PMID: 36710323
PMCID: PMC9885580
DOI: 10.1186/s12903-023-02746-0

Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey

Heba Mohamed Elkhodary et al. BMC Oral Health. 2023.

. 2023 Jan 30;23(1):50.

doi: 10.1186/s12903-023-02746-0.

Authors

Affiliations

¹ Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
² Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt.
³ Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Department of Removable Prosthodontics, Faculty of Dentistry, Minia University, Minia, Egypt.
⁵ Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt.
⁶ Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
⁷ Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE.
⁸ Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
⁹ Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
¹⁰ Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
¹¹ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria.
¹² Dental Public Health Division, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
¹³ Department of Education, University of Kashmir, Srinagar, India.
¹⁴ NHS Tayside Scotland, Dundee, DD2 2RZ, UK.
¹⁵ Department of Biology, Faculty of Science and Technology, Virtual University of Pakistan, Lahore, Pakistan.
¹⁶ Department of Pediatric Dentistry, Faculty of Dental Medicine, Damascus University, Damascus, Syria.
¹⁷ Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
¹⁸ Department of Pediatric, Kids Paradise Dental Center, Seeb, Sultanate of Oman.
¹⁹ Department of Conservative and Preventive Dentistry, Faculty of Dentistry, Saba University, Sana'a, Yemen.
²⁰ Oral Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
²¹ Department of Oral Medicine, Children's Health Research Institute, London, ON, Canada.
²² Western Cape Education Department, Cape Town, South Africa.
²³ Department of Pediatric Dentistry, Clinique Dentaire D'Agadir, Agadir, Morocco.
²⁴ Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt. maha.tantawy@alexu.edu.eg.

PMID: 36710323
PMCID: PMC9885580
DOI: 10.1186/s12903-023-02746-0

Abstract

Background: Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods.

Methods: A multi-country online survey collected data from caregivers of children in 2020-21 about children's use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors).

Results: A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother's education and area of residence (P < 0.05). In addition, children from low income countries had significantly lower odds of using mouthwashes and dental floss than those from high income countries (AOR = 0.55, 95% CI 0.31, 0.98 and AOR = 0.34, 95% CI 0.12, 0.97) whereas children from the European region had higher odds of using mouthwash (AOR = 2.82, 95% CI 1.27, 6.26) and those from the region of the Americas had higher odds of using dental floss (AOR = 3.84, 95% CI 1.28, 11.52) than those from the Eastern Mediterranean region.

Conclusions: The use of various oral hygiene methods is associated with individual, familial and country-level factors. Oral health promotion programs should be developed taking into account these influences.

Keywords: Children; Dental floss; Fluoridated toothpaste; Miswak; Oral health; Oral hygiene; Toothbrush.

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Conflict of interest statement

The authors declare that they have no competing interests. Maha El Tantawi is a Senior Board Member at BMC Oral Health.

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References

1. Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–387. doi: 10.1177/0022034517693566. - DOI - PMC - PubMed
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1. Listl S, Galloway J, Mossey PA, Marcenes W. Global economic impact of dental diseases. J Dent Res. 2015;94(10):1355–1361. doi: 10.1177/0022034515602879. - DOI - PubMed
1. Masood M, Sheiham A, Bernabé E. Household expenditure for dental care in low and middle income countries. PLoS ONE. 2015;10(4):e0123075. doi: 10.1371/journal.pone.0123075. - DOI - PMC - PubMed
1. Lin J, Dinis M, Tseng CH, Agnello M, He X, Silva DR, et al. Effectiveness of the GumChucks flossing system compared to string floss for interdental plaque removal in children: a randomized clinical trial. Sci Rep. 2020;10(1):3052. doi: 10.1038/s41598-020-59705-w. - DOI - PMC - PubMed

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[1] Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–387. doi: 10.1177/0022034517693566. - DOI - PMC - PubMed

[2] Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–387. doi: 10.1177/0022034517693566. - DOI - PMC - PubMed

[3] Abed R, Bernabe E, Sabbah W. Family impacts of severe dental caries among children in the United Kingdom. Int J Environ Res Public Health. 2019;17(1):109. doi: 10.3390/ijerph17010109. - DOI - PMC - PubMed

[4] Abed R, Bernabe E, Sabbah W. Family impacts of severe dental caries among children in the United Kingdom. Int J Environ Res Public Health. 2019;17(1):109. doi: 10.3390/ijerph17010109. - DOI - PMC - PubMed

[5] Listl S, Galloway J, Mossey PA, Marcenes W. Global economic impact of dental diseases. J Dent Res. 2015;94(10):1355–1361. doi: 10.1177/0022034515602879. - DOI - PubMed

[6] Listl S, Galloway J, Mossey PA, Marcenes W. Global economic impact of dental diseases. J Dent Res. 2015;94(10):1355–1361. doi: 10.1177/0022034515602879. - DOI - PubMed

[7] Masood M, Sheiham A, Bernabé E. Household expenditure for dental care in low and middle income countries. PLoS ONE. 2015;10(4):e0123075. doi: 10.1371/journal.pone.0123075. - DOI - PMC - PubMed

[8] Masood M, Sheiham A, Bernabé E. Household expenditure for dental care in low and middle income countries. PLoS ONE. 2015;10(4):e0123075. doi: 10.1371/journal.pone.0123075. - DOI - PMC - PubMed

[9] Lin J, Dinis M, Tseng CH, Agnello M, He X, Silva DR, et al. Effectiveness of the GumChucks flossing system compared to string floss for interdental plaque removal in children: a randomized clinical trial. Sci Rep. 2020;10(1):3052. doi: 10.1038/s41598-020-59705-w. - DOI - PMC - PubMed

[10] Lin J, Dinis M, Tseng CH, Agnello M, He X, Silva DR, et al. Effectiveness of the GumChucks flossing system compared to string floss for interdental plaque removal in children: a randomized clinical trial. Sci Rep. 2020;10(1):3052. doi: 10.1038/s41598-020-59705-w. - DOI - PMC - PubMed

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Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey

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Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey

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