Tooth brushing behaviour in Europe: opportunities for dental public health

Abstract

Although in nearly all European countries there has been an improvement in the levels of dental caries in children and young adults, both dental caries and periodontal breakdown still represent a major public health problem. The improvements have been less marked in many Central and Eastern European countries and there appears to have been no improvement in those from deprived socio-economic groups. Tooth brushing habits in different European countries appear to vary considerably with reports of over 75% of adults and children brushing more than once a day in some countries, but less than 45% doing so in others: plaque levels generally remain high. Systematic reviews have revealed that there is good evidence to show that brushing twice per day with a fluoride toothpaste is effective at preventing dental caries and that this brushing regimen also prevents gingivitis and periodontal breakdown. Recent studies have demonstrated the cost effectiveness of prevention as far as dental caries is concerned. Unfortunately, few studies have investigated the cost effectiveness of prevention of periodontal diseases. It is concluded that improvement in dental public health remains a fundamental need in Europe and that there is an opportunity to address this through changes in tooth brushing behaviour. It is therefore necessary for all dental and general health practitioners, public health workers and the oral care industry, to address this issue together and reach out to those who do not normally attend for oral health care to help them brush effectively twice a day using fluoride toothpaste.