Dental health behavior of parents of children using non-fluoride toothpaste: a cross-sectional study

BACKGROUND One of the dental health goals of Health Japan 21, in which the Japanese government clarified its health policy, was to ensure the use of fluoride toothpaste in 90% or more of schoolchildren. This goal was not achieved. The aim of this cross-sectional questionnaire study was to evaluate the characteristics of parents whose children use non-fluoride toothpaste. METHODS In December 2010, questionnaire forms were sent to 18 elementary schools or school dentists. Students (6-12 years old) were asked to take the forms home for their parents to fill in, and to bring the completed questionnaire to school. The collected questionnaires were mailed from schools to the author's institution by the end of March 2011. The relationship between fluoride in toothpaste and reasons for choice of toothpaste, the child's toothbrushing habits, and attitude toward child caries prevention was examined in the 6,069 respondents who answered all the questions for the analyses and indicated that their children use toothpaste. RESULTS Non-fluoride toothpaste users accounted for 5.1% of all toothpaste users. Among the children using non-fluoride toothpaste, significantly greater numbers gave 'anti-gingivitis', 'halitosis prevention' or 'tartar control' as reasons for choice of toothpaste; did not give 'has fluoride', 'is cheaper' or 'tastes good' as reasons for choice of toothpaste; or used toothpaste sometimes, or were in 4th - 6th grades. There was no significant relationship between use of non-fluoride toothpaste and measures taken for caries prevention in children. Multilevel (first level: individual, second level: school) logistic regression analysis indicated that use of non-fluoride toothpaste was significantly related to: giving 'anti-gingivitis' (odds ratio: 1.44) as a reason for choice of toothpaste; not giving 'has fluoride' (0.40), 'tastes good' (0.49) or 'is cheaper' (0.50) as the reason for choice of toothpaste; to toothbrushing less often (twice a day: 1.34, once a day or less: 1.46) and to using toothpaste less often (sometimes: 1.39). CONCLUSIONS It is necessary to teach parents that dental caries is the dental health issue with the highest priority for children, and therefore fluoride toothpaste should be used.