Correlation Between Brushing Frequency and Self-Reported Dental Problems Among School Students in Hyderabad: A Cross-Sectional Study
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Background: Toothbrushing is a key preventive oral hygiene behavior among schoolchildren, yet oral health complaints may remain common when brushing frequency, brushing technique, or toothbrush selection is inadequate. Objective: To determine the association between toothbrushing frequency, toothbrush bristle type, and self-reported dental problems among school-going children in Hyderabad, Sindh, Pakistan. Methods: This observational cross-sectional study was conducted among 387 school-going children from February 2026 to May 2026 using a structured questionnaire. Data were collected on demographic characteristics, brushing habit, toothbrushing frequency, toothbrush bristle type, and self-reported dental problems, including gingival bleeding, tooth sensitivity, toothache, tooth decay, and discoloration. Categorical variables were summarized as frequencies and percentages. Associations between oral hygiene variables and self-reported dental problems were assessed using the Chi-square test, with p<0.05 considered statistically significant. Results: Of 387 participants, 242 were male and 145 were female. Self-reported dental problems were present in 260 participants. Gingival bleeding was the most frequent complaint, followed by tooth sensitivity and toothache. Toothbrushing frequency was significantly associated with self-reported dental problems, χ²=20.698, p<0.001, based on 372 valid responses. Toothbrush bristle type was also significantly associated with dental problems, χ²=7.031, p=0.030. Conclusion: Infrequent brushing and hard-bristled toothbrush use were associated with a higher prevalence of self-reported dental problems. School-based oral health education should emphasize regular brushing, appropriate toothbrush selection, and early dental consultation
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1. Khan IM, Mani SA, Doss JG, Danaee M, Kong LYL. Pre-schoolers’ tooth brushing behaviour and association with their oral health: a cross sectional study. BMC Oral Health. 2021;21(1):283.
2. Saccomanno S, De Luca M, Saran S, Petricca MT, Caramaschi E, Mastrapasqua RF, et al. The importance of promoting oral health in schools: a pilot study. Eur J Transl Myol. 2023;33(1). doi:10.4081/ejtm.2023.11158.
3. Iba B, Adamu VE. Tooth brushing: an effective oral hygiene measure. Orapuh J. 2021;2(2):1-7. doi:10.4314/orapj.v2i2.1.
4. Rosan B, Lamont RJ. Dental plaque formation. Microbes Infect. 2000;2(13):1599-607. doi:10.1016/S1286-4579(00)01316-2.
5. Valm AM. The structure of dental plaque microbial communities in the transition from health to dental caries and periodontal disease. J Mol Biol. 2019;431(16):2957-69.
6. Almushiti HA, Alnfaie GO, Alotaibi DA, Alsalem NM, Alsumali KM, Alkhamali MS, et al. The impact of modern dietary habits on the prevalence of tooth decay in children and adolescents. Saudi J Med Public Health. 2024;1(2):1384-93.
7. Kshirsagar SB, Takarkhede DS, Jadhav D, Jadhav V, Jadhav V, Jha A. Criticizing the consequences of dental caries: implementing remedies and utilizing dentrifices. J Med Pharm Allied Sci. 2020;9(6):2625-39.
8. Mathur VP, Dhillon JK. Dental caries: a disease which needs attention. Indian J Pediatr. 2018;85(3):202-6. doi:10.1007/s12098-017-2381-6.
9. World Health Organization. Oral health promotion: an essential element of a health-promoting school. Geneva: World Health Organization; 2003.
10. Shahzad HB, Kazmi F, Manzar S, Rashid S, Awais F, Arshad AI, et al. Dental care use and self-reported dental problems in children in Lahore, Pakistan. Pak J Med Health Sci. 2023;17(2):218-21. doi:10.53350/pjmhs2023172218.
11. Shah H, Ahmed S, Talha S, Ayaz S, Saeed TB, Irshad M. Oral health related habits, knowledge, and frequency of dental floss use among undergraduate medical and dental students in a public health sector university in Pakistan: a comparative study. Pak J Med Health Sci. 2022;16(10):274-8. doi:10.53350/pjmhs221610274.
12. Sami E, Vichayanrat T, Satitvipawee P. Caries with dental fluorosis and oral health behaviour among 12-year school children in moderate-fluoride drinking water community in Quetta, Pakistan. J Coll Physicians Surg Pak. 2016;26(9):744-7.
13. Universities N Medical SOF. Comparative analysis of knowledge, attitude and practices regarding tooth brushing habits among students. Pak J Med Cardiol Rev. 2026;5(2):20-31.
14. Gil GS, Morikava FS, Santin GC, Pintarelli TP, Fraiz FC, Ferreira FM. Reliability of self-reported toothbrushing frequency as an indicator for the assessment of oral hygiene in epidemiological research on caries in adolescents: a cross-sectional study. BMC Med Res Methodol. 2015;15:14. doi:10.1186/s12874-015-0002-5.
15. Shah N, Mathur V, Jain V, Logani A. Association between traditional oral hygiene methods with tooth wear, gingival bleeding, and recession: a descriptive cross-sectional study. Indian J Dent Res. 2018;29(2):150. doi:10.4103/ijdr.IJDR_651_16.
16. Zaborskyte A, Bendoraitiene E. Oral hygiene habits and complaints of gum bleeding among schoolchildren in Lithuania. Stomatologija. 2003;5(1):31-6.
17. Tanner M, Singh R, Svellenti L, Hamza B, Attin T, Wegehaupt FJ. Effect of toothbrush bristle stiffness and brushing force on cleaning efficacy. Oral Health Prev Dent. 2023;21:b4100897.