title: Why do children and adolescents neglect dental flossing?
abstract: OBJECTIVE
  To identify the variables and actual difficulties related to children and adolescents' non-compliance with dental flossing.
  
  
  METHODS
  This cross-sectional study with 36 children and 59 adolescents were selected from dental clinics at the Dental School, University of São Paulo. The percentage of surfaces with disclosed biofilm was used to evaluate general oral hygiene. Participants answered questions concerning dental flossing (difficulties, self-reported motivation, and previous instruction). An examiner observed how the participants flossed their teeth and their possible faults. Univariate and multiple logistic regression analyses were performed and odds ratio values were calculated in order to verify the association between non-compliance (or difficulties) with flossing and possible reasons for that.
  
  
  RESULTS
  Similar non-compliance with daily flossing was observed among children and adolescents (p = 0.95). Children's flossing negligence was strongly associated with self-reported laziness in flossing (p = 0.02), and negatively associated with their previous practice by some dentists (p = 0.009). Self-described difficulties in flossing also showed an association with laziness in flossing (p = 0.03). No association was found between negligence of flossing and all variables tested among adolescents (p ≥ 0.05).
  
  
  CONCLUSIONS
  Low compliance and difficulties in flossing among children and adolescents seemed to be more related to lack of motivation, although problems concerning manual skills were also observed.
authors.affiliation: Department of Paediatric Dentistry, Dental School, University of Sao Paulo, São Paulo, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Mattos-Silveira
authors.affiliation: Dental School, University of Camilo Castelo Branco, São Paulo, Brazil.
authors.forename: B B
authors.initials: BB
authors.lastname: Matos-Lima
authors.affiliation: Department of Paediatric Dentistry, Dental School, University of Sao Paulo, São Paulo, Brazil.
authors.forename: T A
authors.initials: TA
authors.lastname: Oliveira
authors.affiliation: Department of Paediatric Dentistry, Dental School, University of Sao Paulo, São Paulo, Brazil.
authors.forename: K
authors.initials: K
authors.lastname: Jarroug
authors.affiliation: Dental School, University of Camilo Castelo Branco, São Paulo, Brazil.
authors.forename: R V
authors.initials: RV
authors.lastname: Rego
authors.affiliation: Dental School, Fundação Hermínio Ometto, Uniararas, Araras, São Paulo, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Reyes
authors.affiliation: Department of Paediatric Dentistry, Dental School, University of Sao Paulo, São Paulo, Brazil.
authors.forename: F R
authors.initials: FR
authors.lastname: Ferreira
authors.affiliation: Department of Paediatric Dentistry, Dental School, University of Sao Paulo, São Paulo, Brazil.|Department of Paediatric Dentistry, São Leopoldo Mandic Dental Research Centre, São Paulo, Brazil.
authors.forename: J C
authors.initials: JC
authors.lastname: Imparato
authors.affiliation: Department of Paediatric Dentistry, Dental School, University of Sao Paulo, São Paulo, Brazil. mmbraga@usp.br.|Faculdade de Odontologia da Universidade de São Paulo, Av. Lineu Prestes, 2227, 05508-000, São Paulo, Brazil. mmbraga@usp.br.
authors.forename: M M
authors.initials: MM
authors.lastname: Braga
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009042:Motivation; D009910:Oral Hygiene / Q000706:statistics & numerical data*
keywords: Adolescent; Child; Compliance; Dental floss