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Toothbrushing behavior changes among korean students pre- and post-COVID-19: lessons and policy implications
Ji-Young Son1, Dong-Hun Han2,3
1Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Korea.
BMC Oral Health
|June 29, 2026
Summary
The COVID-19 pandemic disrupted children's toothbrushing habits in South Korea, reducing post-lunch brushing but increasing bedtime brushing. This highlights the need for flexible school oral health programs during crises.
Area of Science:
- Public Health
- Pediatric Dentistry
- Epidemiology
Background:
- South Korea's School Oral Health Room Program, established in 1999, aimed to improve children's oral hygiene.
- The COVID-19 pandemic significantly disrupted established children's oral hygiene practices.
- Understanding these disruptions is crucial for maintaining oral health interventions.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on toothbrushing practices among South Korean children aged 4-15.
- To compare brushing behaviors before, during, and after the pandemic.
- To inform future public health strategies for pediatric oral hygiene.
Main Methods:
- Analysis of cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES VIII-IX, 2018-2023).
- Inclusion of 5,251 children aged 4-15 years.
- Assessment of toothbrushing behaviors across three periods: pre-pandemic (2018-2019), during pandemic (2020-2021), and post-pandemic (2022-2023), using statistical analyses.
Main Results:
- A marked decline in post-lunch toothbrushing was observed across all age groups during and after the pandemic.
- Toothbrushing before bedtime increased post-pandemic, especially in older children (10-12 years).
- Post-breakfast brushing declined during the pandemic with partial recovery, while other brushing times showed varied trends.
Conclusions:
- The COVID-19 pandemic significantly altered children's toothbrushing routines, notably reducing post-lunch brushing and increasing bedtime brushing.
- These findings emphasize the vulnerability of school-based oral health programs during public health crises.
- Adaptable and resilient oral health strategies are essential to ensure sustained effectiveness.
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