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Toothbrushing and School Refusal in Elementary School: A Longitudinal Study
Yoshifumi Fukuya1, Yusuke Matsuyama1, Aya Isumi1,2
1Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
International Journal of Environmental Research and Public Health
|October 20, 2020
Summary
Children who brush their teeth once daily or less are more likely to refuse school. Promoting daily toothbrushing twice or more may help prevent school refusal in children.
Area of Science:
- Pediatrics
- Public Health
- Behavioral Science
Background:
- School refusal is a significant issue affecting children's education and well-being.
- Oral hygiene habits, such as toothbrushing frequency, are modifiable behaviors with potential health implications.
- Longitudinal data can provide insights into the relationship between early childhood behaviors and later outcomes.
Purpose of the Study:
- To investigate the association between toothbrushing frequency in first-grade children and the incidence of school refusal in second grade.
- To identify toothbrushing frequency as a potential risk factor for school refusal.
- To inform oral health promotion strategies aimed at preventing school refusal.
Main Methods:
- Utilized data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) longitudinal study.
- Collected questionnaire data from 3697 first-grade children (aged 6-7 years).
- Applied propensity score matching to analyze the association between Grade 1 toothbrushing habits and Grade 2 school refusal, controlling for covariates.
Main Results:
- 2.4% of children exhibited school refusal in second grade.
- 23.5% of children brushed their teeth once or less daily in first grade.
- Children brushing once or less daily were 2.25 times more likely to experience school refusal compared to those brushing twice or more daily (95% CI: 1.25-4.05).
Conclusions:
- Brushing teeth once or less daily is an independent risk factor for school refusal in elementary school children.
- Increased toothbrushing frequency (twice or more daily) may serve as a preventive measure against school refusal.
- Further research is needed to explore the underlying mechanisms and causality between oral hygiene and school refusal.
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