The Association Between Toothbrushing Knowledge and Toothbrushing Skills Among Preschool Children: A Cross-Sectional Study

Abstract

Background: Poor oral hygiene remains a significant public health issue among preschool children, often attributed to inadequate oral health literacy and practice. Establishing effective toothbrushing habits early in life is critical, yet the direct relationship between what children know and how they perform remains to be fully elucidated. Objective: This study aimed to investigate the association between toothbrushing knowledge and toothbrushing skills among preschool children. Methods: A cross-sectional study was conducted involving 106 preschool children. Toothbrushing knowledge and practical toothbrushing skills were assessed using validated structured questionnaires and direct observation checklists, categorized into 'Good' and 'Less' levels. Data were analyzed using the Chi-square test with a significance level of p < 0.05. Results: The results revealed that the majority of respondents had less knowledge (77.4%) and less toothbrushing skills (65.1%). Among children with good knowledge (22.6%), 16.0% demonstrated good skills, while 6.6% showed less skills. Conversely, among children with less knowledge, 19.9% possessed good skills, and 58.5% exhibited less skills. Bivariate analysis demonstrated a highly significant association between toothbrushing knowledge and toothbrushing skills among preschool children (p = 0.001). Conclusion: There is a significant association between toothbrushing knowledge and toothbrushing skills in preschool children. Higher knowledge levels correspond to better practical skills, highlighting the urgent need for targeted oral health education and supervised brushing programs in early childhood settings to foster competent oral self-care habits.

Keywords: Toothbrushing knowledge, toothbrushing skills, preschool children, oral hygiene