title: Toothbrushing frequency among 4-6-year-old Iranian children and associated maternal attitude and sociobehavioral factors.
abstract: BACKGROUND
  Toothbrushing is an important aspect of children's oral health self-care. This study aimed to explore toothbrushing frequency among 4-6-year-old Iranian children and associated maternal attitude and sociobehavioral factors.
  
  
  METHODS
  This cross-sectional study was conducted on 407 mother-child (aged 4-6 years) pairs through stratified random sampling in Tabriz, Iran. Data were collected using self-reported questionnaires including demographic characteristic, maternal attitude, and toothbrushing frequency of both mothers and children. Logistic regression was used to determine the predicators of children's toothbrushing. Statistical significance was set atP< 0.05 for all tests.
  
  
  RESULTS
  The mean ages were 32.6 ± 4.8 and 5.3 ± 1.1 years for mothers and children respectively. Twice-daily toothbrushing was observed at a relative frequency of 12.8% in children and 18.4% in mothers. About 43.7% of children brushed their teeth once daily. Nearly 38.7% of children started toothbrushing behavior regularly at 4 years of age, and 41% had dental visits. Multiple logistic regression analysis indicated that children's toothbrushing (once daily or more) was associated with maternal brushing frequency (odds ratio [OR] =2.0, 95% confidence interval [CI] =1.53-2.86), maternal attitude toward oral health (OR = 1.15, CI = 1.08-1.22), and children's age (OR = 1.21, 95% CI = 1.02-1.77).
  
  
  CONCLUSIONS
  The descriptive results indicated that maternal and children toothbrushing behaviors are unfavorable. Furthermore, maternal toothbrushing behavior is a strong predicator of children's brushing behavior. Health promotional activities seem necessary for mothers to enhance oral health behavior of their children.
authors.affiliation: Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Raheleh
authors.initials: R
authors.lastname: Soltani
authors.affiliation: Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ahmad Ali
authors.initials: AA
authors.lastname: Eslami
authors.affiliation: Department of Pediatric Dentistry, Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Najmeh
authors.initials: N
authors.lastname: Akhlaghi
authors.affiliation: Department of Public Health, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Sharifirad
authors.affiliation: Health Center Chancellor, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mikaeil
authors.initials: M
authors.lastname: Alipoor
authors.affiliation: Department of Bio-Statistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Mahaki
keywords: Attitude; child; oral health; toothbrushing