Trends in Children's Toothbrushing in the Czech Republic from 1994 to 2014: Results of the Hbsc Study

By Vašíčková, Jana; Hollein, Tomáš et al. | Central European Journal of Public Health, July 2017 | Go to article overview

Trends in Children's Toothbrushing in the Czech Republic from 1994 to 2014: Results of the Hbsc Study


Vašíčková, Jana, Hollein, Tomáš, Sigmundová, Dagmar, Honkala, Sisko, Pavelka, Jan, Kalman, Michal, Central European Journal of Public Health


INTRODUCTION

Dental hygiene and oral health are a key element of general health and well-being (1). Oral diseases are very common through-out the world, causing pain and discomfort and reducing the quality of life. In addition, their treatment costs considerable amounts of money every year (2). The most common oral diseases, caries and periodontal diseases could be prevented by the adoption of healthy behaviours (3).

Such healthy behaviours are commonly adopted during childhood and adolescence and the main influence comes from the family. In particular, dental care should begin and become regular when a child's first tooth appears. A child has to get used to touching and cleaning the mouth as soon as possible. During the learning of this self-care method with an appropriate brush, the mother is the most important authority until the child is able to use a toothbrush effectively himself or herself. If the teeth are brushed irregularly, it can cause tooth decay and periodontal disease. Moreover, irregular brushing is associated with high levels of cardiovascular diseases, diabetes mellitus, hypertension, and metabolic syndrome (4, 5).

The assessment of oral health in children is vital for planning effective interventions in schools because at that age children are willing to learn new things from a teacher or specialist much more easily than from their parents. Dental health care and related habits in children have not been at the centre of researchers' attention in the Czech Republic. However, oral hygiene has a significant impact on adults and seniors and many measurement instruments are used for the assessment of health-related quality of life (6, 7), but none of them is suitable for children.

The aim of this study was to describe trends in the prevalence of the habit of brushing their teeth more than once a day in six consecutive HBSC surveys between 1994 and 2014 among school-aged children. We hypothesized that a higher proportion of the girls and boys had adopted a habit of brushing their teeth more than once a day in 2014 compared to 1994 and that the trend has an increasing tendency.

MATERIALS AND METHODS

Data from the survey was obtained in six years - 1994, 1998, 2002, 2006, 2010, and 2014 as a part of the Health Behaviour in School-aged Children (HBSC) study in the Czech Republic. The Health Behaviour in School-aged Children study is a collaborative cross-national survey coordinated by the World Health Organization (8). The HBSC protocol was followed in each year in the 11-, 13-, and 15-year-old age groups (8-10). After adjustment of the data according to the age categories, 21,170 questionnaires were entered into the statistical analysis, which was calculated with the IBM SPSS version 22 (11).

The children's oral health was assessed using a mandatory question about the frequency of brushing their teeth validated in the HBSC study (12): "How often do you brush your teeth?" with the possible answers: more than once a day; once a day; at least once a week but not daily; less than once a week; never. For logistic regression (Enter method) we dichotomized the responses to these questions into two categories: more than once a day (reference); children brush their teeth once a day or less than once a day. The independent variable was set to 1994, the first year of the data collection in the Czech Republic. The dependent variables were the following: the years 1998, 2002, 2006, 2010, and 2014.

RESULTS

The whole study sample was collected between 1994 and 2014 and there were 21,170 children involved. Of these 10,276 (48.5%) were boys and 10,894 (51.5%) were girls. Table 1 presents the results from the logistic regression analyses which were performed between the associations of brushing teeth more than once a day in 1994 (reference group) and the other years.

According to the last HBSC world report (13), a significant increasing trend in tooth brushing habits was observed in association with family affluence in all the countries surveyed. …

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