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Why do children and adolescents neglect dental flossing?



To identify the variables and actual difficulties related to children and adolescents’ non-compliance with dental flossing.


This cross-sectional study with 36 children and 59 adolescents were selected from dental clinics at the Dental School, University of São Paulo. The percentage of surfaces with disclosed biofilm was used to evaluate general oral hygiene. Participants answered questions concerning dental flossing (difficulties, self-reported motivation, and previous instruction). An examiner observed how the participants flossed their teeth and their possible faults. Univariate and multiple logistic regression analyses were performed and odds ratio values were calculated in order to verify the association between non-compliance (or difficulties) with flossing and possible reasons for that.


Similar non-compliance with daily flossing was observed among children and adolescents (p = 0.95). Children’s flossing negligence was strongly associated with self-reported laziness in flossing (p = 0.02), and negatively associated with their previous practice by some dentists (p = 0.009). Self-described difficulties in flossing also showed an association with laziness in flossing (p = 0.03). No association was found between negligence of flossing and all variables tested among adolescents (p ≥ 0.05).


Low compliance and difficulties in flossing among children and adolescents seemed to be more related to lack of motivation, although problems concerning manual skills were also observed.

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The authors would like to thank Dr. Flavia Chammas for helping with the clinical attendances and the research proof reading services team for English revision. Furthermore, we are very grateful to the Fundação de Amparo à Pesquisa do Estado de São Paulo (Process 2012/50716-0; 2014/00271-7), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior for their financial support.

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Correspondence to M. M. Braga.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mattos-Silveira, J., Matos-Lima, B.B., Oliveira, T.A. et al. Why do children and adolescents neglect dental flossing?. Eur Arch Paediatr Dent 18, 45–50 (2017).

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  • Dental floss
  • Compliance
  • Child
  • Adolescent