Changes in Toothbrushing Behaviors Following a Child Dental Care Reform in Israel

Efrat Aflalo, Sharon Barak, Sharon Levi, Lilach Ben Meir, Ariela Giladi, Shlomo Paul Zusman, Yossi Harel Fisch, Miri Shachaf, Moti Zwilling, Riki Tesler

Research output: Contribution to journalArticlepeer-review

Abstract

(1) Background: Toothbrushing behavior in children and adolescents is shaped by national dental health policies and sociodemographic and psychological factors. In 2010, child dental care was incorporated into Israel’s National Health Insurance Law (NHIL). This study explored toothbrushing behavior and its predictors before and after this reform. (2) Methods: Data from 36,755 students in grades 6–10 were analyzed from the Health Behaviour in School-Aged Children study conducted pre-reform (1998, 2002, 2006) and post-reform (2010, 2013, 2016). The dependent variable was toothbrushing behavior, while the independent variables included sociodemographic and psychological characteristics. Chi-squared tests compared proportions of compliant toothbrushing behaviors, and logistic regression identified significant predictors. (3) Results: According to recommendations, 59–64% of children brushed their teeth before the reform. This proportion increased significantly post-reform, reaching 73% in 2018. Predictors of compliance included being female, younger, Jewish, and non-observant, having a higher socioeconomic status, and having a better psychological status. These predictors were consistent in pre- and post-reform regression models. (4) Conclusions: The dental care reform positively influenced toothbrushing habits among children and adolescents. However, disparities remain among specific communities. Interventions tailored to address sociodemographic and psychological factors are recommended to enhance regular toothbrushing habits across all populations.

Original languageEnglish
Article number289
JournalChildren
Volume12
Issue number3
DOIs
StatePublished - Mar 2025

Keywords

  • adolescents
  • oral health
  • reform
  • toothbrushing behavior

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