Trends in toothbrushing in 20 countries/regions from 1994 to 2010

Background: For maintaining good oral health, twice-a-day toothbrushing routine is recommended world-wide. As an association between oral diseases and the main non-communicable diseases is confirmed, the importance of brushing is rising. The aim of this article is to describe trends in more-than-once-a-day toothbrushing frequency in 20 countries/regions participating in five consecutive HBSC Surveys between 1994 and 2010. Methods: Eleven-, 13-, and 15-year-old children, who replied to the questionnaire in any of the five surveys, were included ( N = 474 760). Trends were analysed by logistic regression and multilevel logistic regression modelling. Results: Prevalence of recommended toothbrushing behaviour increased in all countries except in Scandinavia, which had already attained a very high level in 1994. The highest increase (more than + 16%) was observed in Estonia, Russia, Latvia, Finland and in Flemish Belgium. Girls had higher prevalence of toothbrushing than boys (OR = 2.06, 99% CI 2.03–2.10). However, the increasing trend was stronger among boys (OR2010 vs. 1994 for boys 1.60; for girls 1.48), and among the younger adolescents (OR2010 vs. 1994 for 11-year-olds 1.64; for 15-year-olds 1.45). Conclusion: Recommended toothbrushing frequency increased in most of the studied countries/regions and differences between the countries diminished during 2004–2010.