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Oral health

What is the influence of oral health literacy on the parents’ choice of fluoride toothpaste?



Investigator blind randomised controlled trial.


One hundred and forty-five parents or carers of children up to four years of age were recruited from families attending a clinic for premature children in Brazil. The aim was to assess the influence of Oral Health Literacy (OHL/OHL-AQ) on the effective and safe use of fluoride toothpaste. The participants were stratified into adequate (12–17) and marginal/inadequate OHL (0–11) and randomly allocated into one of four intervention groups as follows, based on how information was provided: 1. written, 2. oral, 3. written & photograph, 4. oral & photograph. Socioeconomic status was also recorded. Prior to the intervention, the participant’s ability to apply the correct amount of toothpaste (1000 p.p.m F-) was assessed.

Data analysis

Data were analysed using the t-test and one-way ANOVA. The chi-squared test was used to evaluate associations between participants’ ability to select the correct toothpaste, sociodemographic characteristics, oral health habits and OHL.


The majority of the sample were female (89%), with the whole sample’s mean age being 31.9 ± 8.3 years. The OHL-AQ score ranged from 2–16 (mean: 11.3 ± 3.0). Before or after the intervention, having a higher level of OHL was associated with a tendency to deliver the more correct amount of toothpaste onto the brush. The interventions did lead to an improvement in the volume of toothpaste used across all groups. Only schooling was associated with the correct choice of toothpaste.


Parents or guardians with higher OHL used less, and consequently more ideal amounts of, fluoride toothpaste for children compared to those with a lower level of OHL. This was the case both before and after the educational interventions. The allocation to intervention group did not predict the amount of toothpaste used. Finally, only schooling predicted the choice of correct fluoride toothpaste

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Correspondence to Chris Deery.

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Deery, C. What is the influence of oral health literacy on the parents’ choice of fluoride toothpaste?. Evid Based Dent 24, 5–6 (2023).

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