SynthesisBMC oral health2025
Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic review and meta-analysis.
Synthesis in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Effects of graded prevention intervention combined with minimally invasive restoration on the oral health trajectory of caries-susceptible children.Frontiers in public health · 2026Trial
- The Situation and Factors Associated with Dental Caries Among Preschool Children in Nakhon Si Thammarat Province, Thailand.Children (Basel, Switzerland) · 2026Article
- Early twice-daily toothbrushing and adolescent dental caries: a causal inference analysis using the Longitudinal Study of Australian Children.BMC oral health · 2026Article
- Indigenous-non-Indigenous inequalities in oral health prevention among children and adolescents in Ecuador: a cross-sectional study.International journal for equity in health · 2026Article
- Parents' Dental Anxiety in Early Pregnancy and Toothbrushing Stability for Parent and Child Until Age 4-A Longitudinal Study.Dentistry journal · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundEarly childhood caries (ECC) is a prevalent global public health concern. Although daily tooth brushing is a key preventive measure, uncertainty remains regarding the ideal age to initiate tooth brushing and the optimal brushing frequency to minimise ECC risk in preschool children. A systematic review and meta-analysis were conducted to explore the association between tooth brushing practices (initiation age and frequency) and the early childhood caries among children under 6 years of age.
methodsWe searched three databases (Proquest, Web of Science, and Scopus) for observational studies (2000-2024). Quality was assessed with the Newcastle-Ottawa Scale, and random-effects meta-analyses (DerSimonian-Laird) were conducted. Heterogeneity (I2), publication bias (Egger's test), and sensitivity analyses (outlier exclusion) were performed.
resultsThirty-two studies (27 cross-sectional, 5 longitudinal) out of 2833 initially identified records met inclusion criteria. 10 contributed to the brushing initiation meta-analysis and 8 to the frequency analysis. Including all 10 studies, late initiation showed a borderline nonsignificant pooled odds ratio (OR = 1.40, 95% CI: 0.91-2.16, p = 0.13) with I2 > 90%. Excluding one outlier yielded a significant OR = 1.75 (1.50-2.03, p < 0.0001). Brushing < 2 × /day was associated with 2.11-fold higher ECC odds (p = 0.0052), also with heterogeneity but no evidence of publication bias (Egger's p = 0.1161).
conclusionsDespite considerable between-study variability, the overall evidence suggests that commencing tooth brushing by 12 months of age and brushing at least twice daily maybe protective against ECC, highlighting the importance of integrating these practices into early childhood health programs.
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