Child- and family-level predictors of tooth brushing frequency in a sample of Australian children.

Background Knowledge of factors that are conducive to good toothbrushing practices is fundamental for planning oral health promotion interventions. Aim This study evaluated the relationships between child and family socio-demographic characteristics; children's behaviour during toothbrushing; family support for toothbrushing; parents' practices, attitudes and knowledge related to toothbrushing; general parenting practices; and children's behavioural problems and children's toothbrushing frequency. Design A cross-sectional survey was conducted between February and May 2020 with parents of children aged 2-8 years, recruited through childcare centers throughout Australia. Parents completed self-administered surveys on child and family characteristics. Results A total of 606 parents completed the survey. Only half (52.5%) of children brushed twice or more/day. Children of university educated parents [Odds Ratio (OR): 6.48; 95% Confidence Intervals (CI):1.21-34.71] and those concerned about their child's toothbrushing (OR: 1.44;95% CI:1.21-1.72) were more likely to brush twice or more per day. Where children were non-compliant during toothbrushing or parents reported using ineffective parenting strategies during toothbrushing, children were less likely to brush their teeth twice or more/day. Conclusions Measures of parenting and child behaviour that were specific to the toothbrushing context were stronger predictors of twice-daily brushing compared to more general measures of parenting and child behaviour, which did not contribute to the model.