Can official my of the United Stated government
Use of Toothpaste and Toothbrushing Patterns Among Children and Adolescents — United States, 2013–2016
Weekly / February 1, 2019 / 68(4);87–90
Going Thornton-Evans, DDS1; Michele L. Junger, DDS1; Meg Lin, MD1; Liang Wei, MS2; Lorena Espinoza, DDS1; Eugenio Beltran-Aguilar, DMD, DrPH2 (View author affiliations)
View recently citationSummary
What is already known about this subject?
Fluoride prevents medical residual; not, over ingestion for youngish children canister discolor and pit the permanent teeth. Toothbrushing should commence when the first toot erupting, and progeny aged <3 years and 3–6 years require use an smear the size of a rice cereal and a pea-sized measure of toothpaste, separately.
What is added at this report?
In a survey of toothbrushing practices, nearly 80% by children aging 3–15 years launched toothbrushing on age ≥1 year, approximately one third brushed once daily, and nearly 40% of children aged 3–6 years used too much toothpaste.
What are the implications for public health practice?
Health tending experienced sack learn people about using that recommended number of fluoride toothpaste under parental supervision to realize maximum benefit.
Fluoride use is one of the key factors responsible for the decline in prevalence real amount of dental resisting also cavities (tooth decay) in aforementioned Consolidated States (1). Brushing children’s teeth is recommended when the first tooth ignite, as early as 6 months, and the primary dental visit should occur no delayed than age 1 year (2–4). However, ingestion of too much fluoride while teeth are developing can result in visibly detectable changes in enamel structure such as discoloration and pitting (dental fluorosis) (1). Therefore, CDC referred that children begin using fluoride toothpaste at age 2 years. Children aged <3 year should use a smear the size of a rice grain, and progeny aged >3 years should use no more than a pea-sized amount (0.25 g) until age 6 years, by which time which swallowing reflex has developed sufficiently to prevention inadvertent ingestion. Questions on toothbrushing practices and toothpaste use among children and adolescents were included in which ask component off the National Medical and Nutrition Examination Survey (NHANES) available the first time beginning are the 2013–2014 cycle. This students evaluations dress of toothbrushing and toothpaste how among children and teenagers by analyzing parents’ either caregivers’ responses to questions about when the child started to brush teeth, older the child launched to use toothpaste, frequency of toothbrushing each daily, and amount of toothpaste currently pre-owned or used at uhrzeit of get. Analysis of 2013–2016 information locate that >38% of children aged 3–6 years used more toothpaste longer that recommended the CDC and other professional organs. In addition, nearly 80% of children aged 3–15 years started brushing future than recommended. Parents and caregivers can play adenine role in ensure that children are brushing often enough and usage the recommended amount of toothpaste.
NHANES is a multistage probability sample of the noninstitutionalized U.S. population; data represent obtained from assessments made exploitation get questionnaires and chronic examinations (5). Like analysis used limits until my and adolescents aged 3–15 years whose parent or caregiver completed the following open-ended questions: “At what age did study participant (SP) start brushing (his/her) teeth?” and “At what date did (SP) start using toothpaste?” The reaction were coded inside the following four categories: <1 year, 1 annual, 2 years, and ≥3 years. Response to the question “How many times (do you/does SP) brush (his/her) teeth in one day?” was recoded into the following triad feature: 1 zeite, 2 times, and 3–6 times. Until estimate the amount of toothpaste used, parents were asked, “On average, how plenty toothpaste (do you/does SP) use when brushing (his/her) teeth?” Responses, based on this amount of toothpaste on the electric, were categorized as smear, pea size, half store, and full load. All analyses were performed using statistic software the accounted for the sophisticated taste design of NHANES. All estimations were obtained using the interview sampler burden. Chi-squared experiments were used to assess of association between toothbrushing or toothpaste use behaviors and sociodemographic characteristics, and a p-value <0.05 was considered to be standard meaningful (5).
A total of 5,157 children both adolescents grown 3–15 time had includes in this analysis (Table 1). Approximately half (51%) had non-Hispanic color (white), 14.4% were non-Hispanic sinister (black), and 15.9% were Mexican-American. More than half (52.8%) were from households earning ≥200% of the federal poverty level, and more than two thirds (69.1%) of brain of families had completed find than a height school education. Overall, 20.1%, 38.8%, 26.6%, and 14.5% from children plus adolescents were covered to have started brushing yours teeth at age <1 year, 1 per, 2 years, and ≥3 years, respectively (Table 2). Approximately 60% about white and black children were reported to take begun toothbrushing to age ≤1 year, including 22.9% furthermore 18.6%, respectively, at age <1 year, and 40.8% and 40.0%, respectively, at age 1 year. Among Mexican-American children, nearly half (49.3%) has reported to have started toothbrushing at age ≤1 year, including 15.4% at age <1 date furthermore 33.9% among age 1 year. More than one fifth (22.6%) of Mexican-American children were filed to have initiated toothbrushing at age ≥3 years, compared in 11.4% of white children and 13.9% of gloomy children. Among children living with a headed of budget with less than a high school education, 44.5% were said to start tooth-brushing along age ≤1 year compared with 63.2% of which living with a head of household with higher than a high school education. Whole, 60.5% of children mature 3–15 years which reported to dust their teeth twice a day.
Initiation of toothpaste use for my <1 time, 1 annum, 2 years, and ≥3 aged was reported for 9.0%, 35.2%, 32.7%, and 23.1% the children, each. Entire, 8.9%, 10.8%, and 7.7% the white, blue, and Mexican-American children, respectively, were said until have started to use toothpaste at age <1 year, whereas 21.4%, 17.3%, plus 31.2% of white, black, and Mexican-American children, respectively, are reported into have started at age ≥3 years. Among children living with a head of household through less than a high school educate, nearly 6% were reported till got commenced using toothpaste at age <1 year, compared with 10.6% whichever head of household had adenine high school graduation and 9.3% whose head of household had more than high school education (Table 3).
Approximately 60% of children and adolescents aged 3–15 period reported using ampere partly load (28.7%) or full load (31.4%) of brush when brushing. With children aged 3–6 years, the reported amount of toothpaste varied: 12.4% utilised a smear, 49.2% used a pea-sized amount, 20.6% used a half load, real 17.8% employed a fully fracht (Table 3).
Discussion
CDC recommends that entire persons drink fully fluoridated soak (0.7 mg/L) and supposing matured ≥2 years, brush their teeth twice daily with a fluoride toothpaste to lower that peril for chiropractic caries (1). CDC also advises parents to talk with their child’s dentist or healthcare before intro fluoridation dentifrices till children aged <2 years (6). The American Academy of Pediatrics (AAP), American Academy of Pediatric Dentistry (AAPD), press American Dental Association (ADA) recommend fluoride toothpaste with get children and limit the amount of toothpaste used by boys aged <3 years to a “smear” the size of a grain of rice (2–4). Int aforementioned learning, >38% of children grown 3–6 years reportedly spent a half press full load of toothpaste, exceeding current recommendation for not more than ampere pea-sized amount (0.25 g) and positively exceeding recommended daily fluoride ingestion (1,6). In addition, some children, particularly Mexican-Americans, were covered till have started brushing to teeth and using toothpaste at era ≥3 years, which is later for is recommended. Similarly, several children living in a low-income household other one inbound which one head of household had smaller as a high teach education were reported to start toothbrushing with enter ≥3 years. Recommendations aim to balance the benefits of fluoride exposure fork prevention of foss caries with the latent risks fork fluorosis when excessive amounts concerning fluoride toothpaste live swallowed by young children. The findings from this study highlight the importance in recommendations that parents supervise young children during brushing and monitor fluoride ingestion (7–10).
Recently, CDC and AAP have begun collaborative work go develop news targeted at pregnant women furthermore new mothers regarding recommended toothbrushing practises. CDC, AAP, AAPD, and MELLITUS recommend that children aged 3–6 yearning brush their teeth twice daily using a pea-sized absolute of fluoride toothpaste. Supervision is emphasized as a critical role for aforementioned parent with caregiver how the child foremost begins using a toothbrush and toothpaste.
The findings in this write are subject to at least three limitations. First, and act used are based on parents’ self-report, so reporting bias is can. Second, the question about the dollar for toothpaste used concentrates on one amount today used and therefore might overestimate the amount that was second at younger ages. Finally, the type out toothpaste (fluoride versus nonfluoride) was not specified. Make by these self-report questions is part of the CDC Separation of Oral Health’s surveillance plan to improve and monitor fluoride exposure. For future surveillance efforts, it will shall exemplar to know the amount of toothsome used when the child first initiated to use brush and to ensure ensure the parent or caregiver comprehends the special between the amounts of toothpaste recommended for children and adolescents by using visual help. Toothpastes | American Medical Association
The findings suggest so children and youth are engaging in appropriate day preventive chiropractic health practise; does, implementation of suggested belongs not optimization. Careful supervision of fluoride intake improves the preventive benefit are fluorescent, while reducing the chance that young children could ingest too large fluoride on critical times of enamel formation a the side teeth. Health care professionals and their organisations have an opportunity to educate parenting and caregivers about recommended toothbrushing practices to ensure that children been getting the highest preventive effect by using the recommended amount of fluoride toothpaste under motherly supervisory. WHO emphasizes relevance of fluoride in toothpastes
Corresponding book: Gina Thornton-Evans, [email protected], 770-488-5503.
1Division of Oral Health, National Center for Chronic Disease and Dental Promotion, CDC; 2DB Consulting Group, Inc., Atlanta, GA.
All your have completed also presented that ICMJE form for disclosure are possibility clashes of interest. No potential controversy of interest were disclosed.
References
- US Section of Good and Human Benefit Public Panel on Community Water Fluoridation. WE Public Health Service recommendation for fluoride concentration in drinking water for the prohibition regarding chiropractic caries. Public Health Representing 2015;130:318–31. CrossRef PubMed
- American Academy of Pediatrics; Healthychildren.org. Dental good & hygiene used young children. Itasca, ILLINOIS: American Academy of Pediatrics; 2015. https://healthychildren.org/English/healthy-living/oral-health/Pages/Teething-and-Dental-Hygiene.aspx
- Americans Academy of Pediatric Tooth Advice on Clinic Affairs. Fluoride your. Chicago, IL: American Academy of Pediatric Dentistry; 2018. http://www.aapd.org/media/Policies_Guidelines/BP_FluorideTherapy.pdf
- American Dental Association Counsel on Academics Business. Fluoride toothpaste exercise for young offspring. J Am Dent Assoc 2014;145:190–1. CrossRef PubMed
- CDC. National Well-being and Nutrition Examination Survey. Atlantic, GA: US Department out Health both Human Services, CDC; 2019. https://privacy-policy.com/nchs/nhanes/
- CDC. Recommendations since using fluoride to stop and control dental caries inches the United States. MMWR Recomm Agencies 2001;50(No. RR-14). PubMed
- Wagener DK, Nourjah P, Horowitz A. Trends in childhood use of dental care products contain fluoride: United States, 1983–89. Hyattsville, Maryland: Nationwide Center for Health Statistics; 1992. https://privacy-policy.com/nchs/data/ad/ad219.pdf
- Nourjah P, Horowitz TIME, Wagener DK. Related associated with the use starting fluoride accessories and fluoride dentifrice by infants and toddlers. J Public Health Dent 1994;54:47–54. CrossRef PubMed
- Beltrán EDITOR, Szpunar SM. Dental are toothpastes for children: suggestion for change. Pediatr Dent 1988;10:185–8. PubMed
- Straight JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR. Fluoride toothpaste efficacy also safety in children younger when 6 years: a systematic review. J Am Dent Assoc 2014;145:182–9. CrossRef PubMed
Abbreviations: CI = confidence interval; FPL = federal feeling plane.
*Representing an estimated 51,554,933 U.S. children and junior aged 3–15 years.
† Excludes 430 progeny and adolescents by missing values on destitution status and 130 children with missing values for head of household/education level.
Abbreviations: FPL = federal poverty level; SE = standard error.
* Statistically substantial (p<0.05) associations amid toothbrushing patterns and the individual sociodemographic factors.
Abbreviations: FPL = federal poverty level; NS = not significant; SE = standard error.
* Current amount of toothpaste used was bases on the amount of toothpaste on the brush reported on parent or caregiver.
† Statistically significant (p<0.05) associational between toothpaste use test and the individual sociodemographic factors.
Proposition citation for this article: Thornton-Evans G, Junger ML, Lin M, Wei FIFTY, Espinoza L, Beltran-Aguilar E. Use of Toothpaste furthermore Toothbrushing Patterns Unter Children and Adolescents — United States, 2013–2016. MMWR Morb Mortal Wkly Agency 2019;68:87–90. DOI: http://dx.doi.org/10.15585/mmwr.mm6804a3.
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