Tooth-brushing and dentifrice use among children ages 6 to 60 months

Tooth-brushing and fluoride dentifrice use are the primary oral health activities for young children. Fluoridated dentifrice has had an important impact on the reduction in children's caries lesion rates, but no studies have focused on patterns of use at multiple time points early in life. The purpose of this paper is to describe tooth-brushing and fluoride dentifrice use in a cohort of children from ages 6 to 60 months.

The data are from the Iowa Fluoride Study, a longitudinal investigation of fluoride intake from birth. Questionnaires assessed tooth-brushing patterns and fluoride dentifrice use at age 6 months, and at 3-, 4-, or 6-month intervals thereafter.

At 6 months of age, 28% of the children's teeth were brushed or cleaned, and 3% of these used fluoridated dentifrice, increasing to 95% at 20 months (83% of them with fluoridated dentifrice). Use of dentifrice flavored for children increased from 40% of those brushing at 9 months to 71% at 60 months. From 9 to 32 months, about 55% of the children were using approximately the recommended amount of dentifrice. However, the percentage using more than recommended increased from 12% at 9 months to 64% at 60 months. Mothers placed the dentifrice on the toothbrush 85% of the time at 9 months, 81% at 20 months, 49% at 36 months, and 31% at 60 months.

By age 2, almost all children were brushing with fluoridated dentifrice, but less than half brushed twice a day, even at age 5. Mothers played the most important role in the children's home care habits.