A new study published in the journal of BMC Oral Health showed that the overall evidence indicates that starting to brush teeth by 12 months of age and doing so at least twice a day may be protective against early childhood caries (ECC), despite significant between-study variability. This emphasizes the significance of incorporating these practices into early childhood health programs.
Caries in young children is still a prevalent but avoidable ailment. Effective plaque management, fluoride exposure, and good oral habits depend on determining the ideal age to start brushing teeth and the right frequency of brushing. Long-term kid dental health can be supported by early preventative measures that dramatically lower the risk of caries. To investigate the relationship between early childhood caries in children under the age of 6 and teeth brushing behaviors (initiation age and frequency), this study was carried out.
This research looked for observational studies (2000–2024) from Web of Science, Proquest, and Scopus. The Newcastle-Ottawa Scale was used to evaluate quality, and DerSimonian-Laird random-effects meta-analyses were carried out. Sensitivity analyses (outlier exclusion), heterogeneity (I2), and publication bias (Egger's test) were carried out.
Of the 2833 records that were initially found, 32 studies (27 cross-sectional and 5 longitudinal) satisfied the inclusion criteria. 8 participated to the frequency analysis and ten to the meta-analysis of brushing beginning. When all ten trials were included, the pooled odds ratio for late commencement was borderline nonsignificant (OR = 1.40, 95% CI: 0.91–2.16, p = 0.13) with I2 > 90%. A significant OR = 1.75 (1.50–2.03, p < 0.0001) was obtained by excluding one outlier.
Brushing less than two times a day was linked to a 2.11-fold increase in ECC chances (p = 0.0052), with heterogeneity but no indication of publication bias (Egger's p = 0.1161). Overall, early teeth brushing (before age 1) and brushing at least twice a day generally decreased the incidence of ECC in preschoolers, according to this systematic review and meta-analysis. However, it is important to use care when interpreting pooled findings due to the substantial variation in effect sizes, definitions, and possible outlier influences.
A single outlier research can alter the relevance and size of results, according to sensitivity analysis, highlighting the need of standardized procedures and careful confounder correction. However, the overwhelming body of research supports the existing recommendations for early and regular brushing as a means of preventing early childhood caries.
Source:
Al-Sharani, H. M., Stormon, N., Al-Hutbany, N., Zhang, Y., & Zulfiqar, T. (2025). Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic review and meta-analysis. BMC Oral Health, 25(1), 2006. https://doi.org/10.1186/s12903-025-07179-5
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