Association between Level of Parental Oral Health Literacy and the Rational Use of Fluoride for Children from 0 to 4 Years of Age after Instruction: An Intervention Trial

Abstract

An inadequate level of oral health literacy (OHL) can hinder the understanding of dental information, which can have a negative impact on health promotion actions, such as the rational use of fluoride. The aims of the present study were: 1) to look for association between parents/guardians´ OHL and the amount of fluoride toothpaste used for children from zero to four years of age; 2) to compare the effect of different modes of educational interventions on the amount of fluoride toothpaste used for children from zero to four years of age; 3) to assess the ability of parents/guardians to choose a toothpaste with adequate fluoride concentration, after the educational intervention. A randomized intervention study was conducted with parents/guardians of children zero to four years of age (n = 145). The participants answered the Oral Health Literacy Adults Questionnaire and a questionnaire addressing sociodemographic characteristics. The participants were allocated to four intervention groups based on type of counseling (written, oral, written + photograph and oral + photograph) with randomization stratified by level of OHL. The participants were instructed to place the adequate amount of toothpaste on a toothbrush for children zero to four years of age (smear of 0.125 mg) before and after the intervention. The correct choice of toothpaste was also evaluated by the interpretation of the labels of four toothpastes of different brands and with different concentrations of fluoride. Associations between variables were tested using the Student’s t-test and one-way ANOVA. Level of OHL was associated with the amount of fluoride toothpaste deposited prior to the educational intervention (p = 0.021) and the percentage of approximation to the appropriate amount of fluoride toothpaste (p < 0.05). The choice of toothpaste was associated with schooling (p = 0.031). In conclusion, parents/guardians with adequate OHL better quantified fluoride toothpaste before and after the educational intervention and also came closer to the appropriate amount of toothpaste after the educational intervention. No significant differences in the final amount of toothpaste placed of the toothbrush were found among the intervention groups. The choice of the correct toothpaste was associated with a higher level of schooling.

Dental Practice Websites in Germany—How Do They Inform about Fluoridation?

“…Receiving contradictory information about fluoridation in children can therefore quickly lead to misjudgments about the correct use of fluorides [ 30 ]. A recently published study showed that parents have difficulties with managing their children’s oral health without guidance [ 31 ]. This covered choosing the right toothpaste for their child’s age and determining the correct amount of toothpaste to use, which has a direct impact on the use of fluoride in children [ 31 ].…”

“…A recently published study showed that parents have difficulties with managing their children’s oral health without guidance [ 31 ]. This covered choosing the right toothpaste for their child’s age and determining the correct amount of toothpaste to use, which has a direct impact on the use of fluoride in children [ 31 ]. By providing specialist articles on their websites, dentists have a major opportunity to influence the correct provision of information for patients.…”