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Use of fluoridated dentifrices by children in Araçatuba, Brazil: factors affecting brushing habits and amount applied on the brush

Abstract

Purpose

To evaluate the type and the amount of fluoridated dentifrice applied on children’s toothbrushes by parents/guardians according to descriptions typically recommended by scientific societies, as well as to assess the influence of demographic and socioeconomic variables on dentifrice use.

Methods

Parents/guardians of children (0–7 years old; n = 306; convenience sample) attending vaccination centres from Araçatuba (Brazil), answered to a structured questionnaire comprising items related to interviewees’ education, child’s age, gender, brushing habits and use of fluoridated dentifrice. The amount of toothpaste used by children during toothbrushing was estimated using a portable scale. Similarly, the interviewees were requested to apply dentifrices on toothbrushes according to eight descriptions, ranging from “smear” to “all bristles”, following a random sequence. Data were submitted to Mann–Whitney’s, Kruskal–Wallis’ and Friedman’s tests, and Spearman’s correlation coefficient (p < 0.05).

Results

The type of toothpaste and the amount of product used at home were not affected by the respondents’ educational level or family income. However, child’s age was significantly correlated with the amount of toothpaste placed on the toothbrush (r = 0.324, p < 0.001). Also, the amount of toothpaste placed on the toothbrush increased according to what would be expected from the descriptions, although wide variations were observed within each description, with large interquartile and overall ranges.

Conclusion

The amount and the type of dentifrice used by children were influenced by their age, while parents/caregivers’ interpretation on verbal instructions regarding appropriate dentifrice quantities varied widely. This reinforces the need for educative measures on the appropriate use by dentifrices by children.

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References

  1. American Academy of Pediatric Dentistry. Fluoride therapy. The reference manual of pediatric dentistry. Chicago, Ill. American Academy of Pediatric Dentistry. 2020; pp. 288–91.

  2. Boustedt K, Dahlgren J, Twetman S, Roswall J. Tooth brushing habits and prevalence of early childhood caries: a prospective cohort study. Eur Arch Paediatr Dent. 2020;21(1):155–9. https://doi.org/10.1007/s40368-019-00463-3.

    Article  PubMed  Google Scholar 

  3. Buzalaf MA, Rodrigues MH, Pessan JP, Leite AL, Arana A, Villena RS, Forte FD, Sampaio FC. Biomarkers of fluoride in children exposed to different sources of systemic fluoride. J Dent Res. 2011;90:215–9. https://doi.org/10.1177/0022034510385937.

    Article  PubMed  Google Scholar 

  4. Cunha RF, Delbem AC, Percinoto C, Saito TE. Dentistry for babies: a preventive protocol. ASDC J Dent Child. 2000;67:89–92.

    PubMed  Google Scholar 

  5. de Almeida BS, da Silva Cardoso VE, Buzalaf MA. Fluoride ingestion from toothpaste and diet in 1- to 3-year-old Brazilian children. Commun Dent Oral Epidemiol. 2007;35:53–63. https://doi.org/10.1111/j.1600-0528.2007.00328.x.

    Article  Google Scholar 

  6. ElKarmi R, Shore E, O’Connell A. Knowledge and behaviour of parents in relation to the oral and dental health of children aged 4–6 years. Eur Arch Paediatr Dent. 2015;16(2):199–204. https://doi.org/10.1007/s40368-014-0155-7.

    Article  PubMed  Google Scholar 

  7. Fux-Noy A, Ytshaki K, Herzog K, Shmueli A, Halperson E, Ram D. Dentists, dental hygienists and dental students’ knowledge regarding recommended fluoride concentration in toothpaste for children. Eur Arch Paediatr Dent. 2020;21(5):623–7. https://doi.org/10.1007/s40368-019-00507-8.

    Article  PubMed  Google Scholar 

  8. Hall KB, Delbem AC, Nagata ME, Hosida TY, de Moraes FR, Danelon M, Cunha RF, Pessan JP. Influence of the amount of dentifrice and fluoride concentrations on salivary fluoride levels in children. Pediatr Dent. 2016;38:379–84.

    PubMed  Google Scholar 

  9. Kobayashi CA, Belini MR, Italiani Fde M, Pauleto AR, Araújo JJ, Tessarolli V, Grizzo LT, Pessan JP, Machado MA, Buzalaf MA. Factors influencing fluoride ingestion from dentifrice by children. Commun Dent Oral Epidemiol. 2011;39:426–32. https://doi.org/10.1111/j.1600-0528.2011.00615.x.

    Article  Google Scholar 

  10. Li J, Dallas S, McBride-Henry K. Use of full strength fluoride toothpaste among preschoolers in New Zealand, and factors determining toothpaste choice. N Z Med J. 2016;129:44–51.

    PubMed  Google Scholar 

  11. Miziara AP, Philippi ST, Levy FM, Buzalaf MA. Fluoride ingestion from food items and dentifrice in 2–6-year-old Brazilian children living in a fluoridated. Commun Dent Oral Epidemiol. 2009;37:305–15. https://doi.org/10.1111/j.1600-0528.2009.00477.x.

    Article  Google Scholar 

  12. Moraes SM, Pessan JP, Ramires I, Buzalaf MA. Fluoride intake from regular and low fluoride dentifrices by 2–3-year-old children: influence of the dentifrice flavor. Braz Oral Res. 2007;21:234–40. https://doi.org/10.1590/s1806-83242007000300008.

    Article  PubMed  Google Scholar 

  13. Oliveira BH, Grisolia BM, dos Santos APP. Children’s toothbrushing practices recommended on the internet by Pediatric Dentistry Associations. Pediatr Dent. 2016;38:484–8.

    PubMed  Google Scholar 

  14. Paiva MF, Delbem ACB, Danelon M, Nagata ME, Moraes FRN, Coclete GEG, Cunha RF, Buzalaf MAR, Pessan JP. Fluoride concentration and amount of dentifrice influence enamel demineralization in situ. J Dent. 2017;66:18–22. https://doi.org/10.1016/j.jdent.2017.09.004.

    Article  PubMed  Google Scholar 

  15. Palmada E, Gallazzini C, Barria K, Licht L, Marie-Cousin A, Sixou JL. Fluoride: changes in knowledge and prescription habits of paediatricians for 11 years in Brittany, France. Eur Arch Paediatr Dent. 2017;18(1):51–8. https://doi.org/10.1007/s40368-016-0267-3.

    Article  PubMed  Google Scholar 

  16. Pessan JP, Toumba KJ, Buzalaf MA. Topical use of fluorides for caries control. Monogr Oral Sci. 2011;22:115–32. https://doi.org/10.1159/000325154.

    Article  PubMed  Google Scholar 

  17. Sampaio C, Delbem ACB, Paiva MF, Zen I, Danelon M, Cunha RF, Pessan JP. Amount of dentifrice and fluoride concentration influence salivary fluoride concentrations and fluoride intake by toddlers. Caries Res. 2020;54(3):234–41. https://doi.org/10.1159/000503780.

    Article  PubMed  Google Scholar 

  18. Sebastian ST, Soman RR, Sunitha S. Prevalence of dental fluorosis among primary school children in association with different water fluoride levels in Mysore district, Karnataka. Indian J Dent Res. 2016;27:151–4. https://doi.org/10.4103/0970-9290.183126.

    Article  PubMed  Google Scholar 

  19. Toumba KJ, Twetman S, Splieth C, Parnell C, van Loveren C, Lygidakis NΑ. Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. Eur Arch Paediatr Dent. 2019;20(6):507–16. https://doi.org/10.1007/s40368-019-00464-2.

    Article  PubMed  Google Scholar 

  20. Walsh T, Worthington HV, Glenny AM, Marinho VC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev. 2019. https://doi.org/10.1002/14651858.CD007868.pub3.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wong MC, Glenny AM, Tsang BW, Lo EC, Worthington HV, Marinho VC. Topical fluoride as a cause of dental fluorosis in children. Cochrane Database Syst Rev. 2010. https://doi.org/10.1002/14651858.CD007693.pub2.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zero DT, Creeth JE, Bosma ML, Butler A, Guibert RG, Karwal R, Lynch RJ, Martinez-Mier EA, González-Cabezas C, Kelly SA. The effect of brushing time and dentifrice quantity on fluoride delivery in vivo and enamel surface microhardness in situ. Caries Res. 2010;44:90–100. https://doi.org/10.1159/000284399.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank to Prof. Robson Cunha and Prof. Mayra Paiva for their valuable assistance in drafting the questionnaires used in this study.

Funding

This study was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001 and scholarship granted to the first author, which played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors

Contributions

ACDB, and JPP contributed to the study conception and design. Material preparation, data collection, and analysis were performed by GEGC, ACBD, CS, MD, DRM, and JPP. The first draft of the manuscript was written by GEGC, CS, and JPP, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to J. P. Pessan.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Human Research Ethics Committee of School of Dentistry, Araçatuba—UNESP (CAAE 67074217.7.0000.5420).

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Coclete, G.E.G., Delbem, A.C.B., Sampaio, C. et al. Use of fluoridated dentifrices by children in Araçatuba, Brazil: factors affecting brushing habits and amount applied on the brush. Eur Arch Paediatr Dent 22, 979–984 (2021). https://doi.org/10.1007/s40368-021-00663-w

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Keywords

  • Fluorides
  • Child
  • Toothpastes
  • Dental caries
  • Fluorosis
  • Dental