Changes in toothbrushing and factors associated with less than twice daily toothbrushing by the age of four in the FinnBrain Birth Cohort Study

Authors

  • Hanna Suokko Department of Community Dentistry, University of Turku, Turku, Finland; Unit of Medical Education, Education and Research, The Wellbeing Services County of Pirkanmaa, Tampere, Finland https://orcid.org/0000-0003-3961-0669
  • Mimmi Tolvanen Emergency Services Academy Finland, Kuopio, Finland https://orcid.org/0000-0002-0889-8164
  • Jorma Virtanen Department of Community Dentistry, University of Turku, Turku, Finland; Faculty of Medicine, University of Bergen, Bergen, Norway https://orcid.org/0000-0001-6574-9942
  • Auli Suominen Department of Community Dentistry, University of Turku, Turku, Finland https://orcid.org/0000-0002-2642-9003
  • Linnea Karlsson FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Wellbeing Services County of Southwest Finland, Turku, Finland; Unit of Public Health, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland; Department of Psychiatry, Unit of Child Psychiatry, Turku University Hospital, Turku, Finland https://orcid.org/0000-0002-4725-0176
  • Hasse Karlsson FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland; Department of Psychiatry, Unit of Child Psychiatry, Turku University Hospital, Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland https://orcid.org/0000-0002-4992-1893
  • Satu Lahti Department of Community Dentistry, University of Turku, Turku, Finland; FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Wellbeing Services County of Southwest Finland, Turku, Finland https://orcid.org/0000-0003-3457-4611

DOI:

https://doi.org/10.2340/aos.v85.46661

Keywords:

Oral health behavior, toothbrushing, children, parents

Abstract

This study examined toothbrushing and its associated factors in children aged 1–4 years, using data from 306 mother-father-dyads and their 308 children participating in the FinnBrain Birth Cohort Study. Longitudinal multivariable regression analysis was conducted using the generalized estimating equation method to model the outcome, parent-reported brushing of a child’s teeth less than twice daily at the child’s age of 12, 24 and 48 months, controlling for the intraindividual correlation between repeated measurements using compound symmetry (correlation structure). The independent variables as time-varying covariates from 12 to 48 months were mother’s and father’s own toothbrushing, couple relationship satisfaction, number of positive life events of father, and fixed covariates were number of siblings, education level of mother and age of parents. Among the children, 50% had stable good and 16% stable poor toothbrushing habits from 1 to 4 years. Both parents’ less than twice daily brushing was strongly associated with less than twice daily brushing of a child’s teeth. The strength of the association between brushing mother’s own and the child’s teeth varied across time, whereas this association in fathers remained consistent. Early family-based intervention is crucial for promoting parents’ own brushing habits and thereby supporting children’s oral hygiene.

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2026-08-11

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Vol. 85: (2026): Acta Odontologica Scandinavica

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Copyright (c) 2026 Hanna Suokko, Mimmi Tolvanen, Jorma Virtanen, Auli Suominen, Linnea Karlsson, Hasse Karlsson, Satu Lahti

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