Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Investigating the prevalence of non-fluoride toothpaste use in adults and children using nationally representative data from New Zealand: a cross-sectional study

British Dental Journal volume 228, pages 269–276 (2020)Cite this article

Abstract

Introduction Despite improvements in oral health outcomes in New Zealand over the last number of decades, there are still high levels of preventable tooth decay in adults and children. We investigate the prevalence and spatial variation of non-fluoride toothpaste use in a nationally representative sample of adults and children in New Zealand.

Method Individual-level self-reported data were sourced from the New Zealand Health Survey (2017/18). Both child (n = 4,723) and adult (n = 13,869) data were used. Data included sociodemographic (for example, age), socioeconomic (for example, area-level deprivation) and dental-related (for example, type of toothpaste used) variables.

Results Overall, 6.8% of adults and 6.4% of children use non-fluoride toothpaste. When split by deprivation, the highest prevalence of non-fluoride toothpaste use for children and adults was in the moderate to least deprived areas, while the lowest prevalence was in the most deprived areas. When disaggregated by ethnicity, the Asian population had the highest prevalence of non-fluoride toothpaste use for both adults and children compared to Māori, Pacific and European/Other. There was little difference in prevalence by rural/urban classification; however, prevalence varied geographically across the study area.

Conclusion This is the first study that uses a nationally representative sample of adults and children to show variation in the use of non-fluoride toothpaste in New Zealand.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Vos T, Abajobir A A, Abate K H et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1211-1259.

  2. Featherstone J D. The science and practice of caries prevention. J Am Dent Assoc 2000; 131: 887-899.

    Article  Google Scholar 

  3. Caufield P W, Griffen A L. Dental caries: An infectious and transmissible disease. Pediatr Clin North Am 2000; 47: 1001-1019.

    Article  Google Scholar 

  4. Featherstone J D, Adair S M, Anderson M H et al. Caries management by risk assessment: consensus statement, April 2002. J Calif Dent Assoc 2003; 31: 257-269.

  5. Selwitz R H, Ismail A I, Pitts N B. Dental caries. Lancet 2007; 369: 51-59.

    Article  Google Scholar 

  6. Ministry of Health. Our Oral Health: Key findings of the 2009 New Zealand Oral Health Survey. Wellington: Ministry of Health, 2010. Available online at https://www.health.govt.nz/publication/our-oral-health-key-findings-2009-new-zealand-oral-health-survey (accessed January 2020).

  7. Wade A, Hobbs M, Green M A. Investigating the relationship between multimorbidity and dental attendance: a cross-sectional study of UK adults. Br Dent J 2019; 226: 138-143.

    Article  Google Scholar 

  8. Sabbah W, Tsakos G, Chandola T, Sheiham A, Watt R G. Social Gradients in Oral and General Health. J Dent Res 2007; 86: 992-996.

    Article  Google Scholar 

  9. Shackleton N, Broadbent J M, Thornley S, Milne B J, Crengle S, Exeter DJ. Inequalities in dental caries experience among 4yearold New Zealand children. Community Dent Oral Epidemiol 2018; 46: 288-296.

    Article  Google Scholar 

  10. Aung Y M, Tin Tin S, Jelleyman T, Ameratunga S. Dental caries and previous hospitalisations among preschool children: findings from a population-based study in New Zealand. N Z Med J 2019; 132: 44-53.

  11. Walsh T, Worthington H V, Glenny A M, Marinho V C, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; DOI: 10.1002/14651858.CD007868.pub3.

  12. The Lancet. Oral health: prevention is key. Lancet 2009; 373: 1.

  13. Casamassimo P S, Thikkurissy S, Edelstein B L, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc 2009; 140: 650-657.

    Article  Google Scholar 

  14. Azarpazhooh A, Main P A. Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic review. J Can Dent Assoc 2008; 74: 73-79.

  15. Ministry of Health. District health boards. 2020. Available online at https://www.health.govt.nz/new-zealand-health-system/key-health-sector-organisations-and-people/district-health-boards (accessed January 2020).

  16. Ministry of Health. Methodology Report 2016/17: New Zealand Health Survey. 2017. Available online at https://www.health.govt.nz/publication/methodology-report-2016-17-new-zealand-health-survey (accessed July 2018).

  17. Hobbs M, Tomintz M, McCarthy J et al. Obesity risk in women of childbearing age in New Zealand: a nationally representative cross-sectional study. Int J Public Health 2019; 64: 625-635.

    Article  Google Scholar 

  18. Atkinson J, Salmond C, Crampton P. NZDep2013 Index of Deprivation. 2014. Available online at https://www.otago.ac.nz/wellington/otago069936.pdf (accessed January 2020).

  19. Ministry of Health. Guidelines for the use of fluorides. Wellington: Ministry of Health, 2009. Available online at https://www.health.govt.nz/publication/guidelines-use-fluorides (accessed January 2020).

  20. World Health Organisation. The world oral health report 2003: continuous improvement of oral health in the 21st century - the approach of the WHO Global Oral Health Programme. 2003. Available online at https://www.who.int/oral_health/media/en/orh_report03_en.pdf (accessed January 2020).

  21. Ruff R R, Senthi S, Susser S R, Tsutsui A. Oral health, academic performance, and school absenteeism in children and adolescents: A systematic review and meta-analysis. J Am Dent Assoc 2019; 150: 111-121.

    Article  Google Scholar 

  22. Jackson S L, Vann W F Jr, Kotch J B, Pahel B T, Lee J Y. Impact of poor oral health on children's school attendance and performance. Am J Public Health 2011; 101: 1900-1906.

    Article  Google Scholar 

  23. Marmot M. The Health Gap: The Challenge of an Unequal World: the argument. Int J Epidemiol 2017; 46: 1312-1318.

    Article  Google Scholar 

  24. Ministry of Health. Reducing Inequalities in Health. 2002. Available online at https://www.health.govt.nz/publication/reducing-inequalities-health (accessed January 2020).

  25. Hobbs M, Duncan M J, Collins P et al. Clusters of health behaviours in Queensland adults are associated with different socio-demographic characteristics. J Public Health (Oxf) 2018; 41: 268-277.

    Article  Google Scholar 

  26. Marmot M. Social determinants of health inequalities. Lancet 2005; 365: 1099-1104.

    Article  Google Scholar 

  27. Marmot M. The health gap: the challenge of an unequal world. Lancet 2015; 386: 2442-2444.

    Article  Google Scholar 

  28. Locker D. Deprivation and oral health: a review. Community Dent Oral Epidemiol 2000; 28: 161-169.

    Article  Google Scholar 

  29. Williams O. Identifying adverse effects of area-based health policy: An ethnographic study of a deprived neighbourhood in England. Health Place 2017; 45: 85-91.

    Article  Google Scholar 

  30. Frohlich K L, Potvin L. Transcending the Known in Public Health Practice. Am J Public Health 2008; 98: 216-221.

    Article  Google Scholar 

  31. Merton R. The unanticipated consequences of purposive social action. Am Sociol Rev 1936; 1: 894-904.

    Article  Google Scholar 

Download references

Acknowledgements

This research was carried out as part of the GeoHealth Laboratory work programme at the University of Canterbury, funded by the New Zealand Ministry of Health. The authors thank the participants within the New Zealand Health Survey. Access to the data used in this study was provided by the New Zealand Ministry of Health under conditions designed to keep individual information confidential and secure in accordance with the requirements of the Health Information Privacy Code 1994 and the Privacy Act 1993. The New Zealand Health Survey was funded by the New Zealand Ministry of Health.

Funding

This research was carried out as part of the GeoHealth Laboratory work programme at the University of Canterbury, funded by the New Zealand Ministry of Health.

Author information

Authors and Affiliations

  1. GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, New Zealand

    Matthew Hobbs, Lukas Marek, Melanie Tomintz, Malcolm Campbell & Simon Kingham

  2. Ministry of Health, Wellington, New Zealand

    Riana Clarke & John McCarthy

  3. Registered Dentist, New Zealand

    Alicia Wade

Authors
  1. Matthew Hobbs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lukas Marek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Riana Clarke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John McCarthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Melanie Tomintz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alicia Wade
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Malcolm Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Simon Kingham
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

M. Hobbs; Postdoctoral Researcher, GeoHealth Laboratory; conception and development of idea, data analysis, interpretation of results, editing of manuscript. L. Marek; Postdoctoral Researcher, GeoHealth Laboratory; editing of manuscript, data analysis advice. R. Clarke; National Clinical Director Oral Health, registered dentist; conception of idea and editing of the manuscript. J. McCarthy; Principal Technical Specialist - Geospatial, Ministry of Health; conception of idea and editing of the manuscript. M. Tomintz; Research Manager, GeoHealth Laboratory; editing of manuscript. A. Wade; registered dentist; conception of idea and editing of the manuscript. M. Campbell; Deputy Director, GeoHealth Laboratory; editing of manuscript. S. Kingham; Director, GeoHealth Laboratory; initial brainstorming for conception of idea and editing of manuscript.

Corresponding author

Correspondence to Matthew Hobbs.

Ethics declarations

The authors declare that they have no conflict of interest.

Electronic supplementary material

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hobbs, M., Marek, L., Clarke, R. et al. Investigating the prevalence of non-fluoride toothpaste use in adults and children using nationally representative data from New Zealand: a cross-sectional study. Br Dent J 228, 269–276 (2020). https://doi.org/10.1038/s41415-020-1304-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-020-1304-5

Search

Advanced search

Quick links