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Cosmetic, Immediate Benefits Drive Kids' Tooth Brushing
March 20, 2014

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Most people know that brushing children's teeth helps to keep their mouths healthy. So why don't all parents and caregivers make sure it's done?

A small, in-depth study from the Cardiff School of Dentistry, Wales, tried to get some answers to this question. The study included 15 parents of young children. They were interviewed by phone. All parents lived in low-income areas. Their children were between 3 and 6 years old. They went to day-care centers or schools taking part in a tooth-brushing education program called Designed to Smile.

Interviews started with three open-ended questions:

  • Tell me about your experience with brushing your child's teeth at home.
  • What things make brushing your child's teeth easier for you?
  • What things make brushing your child's teeth harder for you?

Follow-up questions and statements encouraged parents to share more information.

These were the study's main findings:

  • Households with more stable morning and evening routines were more likely to treat brushing as a given, rather than a choice.
  • Parents were motivated to brush their child's teeth by short-term, cosmetic benefits (fresh breath, clean-looking teeth).
  • Parents' perceptions of how other parents handled tooth-brushing were important.


The researchers found that tooth brushing often occurred as part of a morning or evening routine. For these 15 families, evenings were often less predictable than mornings, due to work schedules and other activities. Many children were with other family members or friends after school. They ate dinner at different times and places throughout the week.

Parents who reported a lack of evening routine said that it was a struggle to get their child's teeth brushed at night. Brushing was often not done in the evenings, although parents knew it was important.

Parents who reported more consistency in their morning or at night routines were more likely to view brushing as a habit. They did not see it as optional. It was something that was done every day, like getting dressed.


Researchers also asked about why people brushed. Many parents said that brushing in the morning was done to make teeth clean, and breath fresh, for the day ahead. They said this was like ensuring that the children's clothes were clean and faces were washed before they went to school.

Parents did not have such concrete motivations for brushing at night. A couple of parents said they did not see the point of brushing at night if brushing would be done the next morning.


Nearly every parent referred to the "twice a day" rule for tooth brushing at some point during the phone interview. However, parents tended to believe that rule was important only if they thought most other parents followed it. Parents who did not make sure their children brushed twice a day believed that most other parents didn't, either.

When asked how satisfied they were with how often their children brushed, parents compared themselves to other parents. Most did not talk about their child's oral health.

Dental professionals tend to encourage regular brushing due to its long-term benefits: the prevention of tooth decay, gum disease and other oral problems. But parents in this study were motivated by short-term, cosmetic benefits: fresh breath and having teeth that looked clean.

The study authors suggest further studies to understand parents' attitudes, beliefs and motivation. The new knowledge could help to develop more effective educational campaigns or other ways to encourage brushing.

The study appears in the March issue of the International Journal of Paediatric Dentistry.

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