Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years): Early childhood caries (ECC)
- Population
- Healthy children under 6 years of age (6 months to 6 years); preschool children
- Intervention
- Late tooth brushing initiation (>=12 months, or >=2 years in some studies)
- Comparison
- Early tooth brushing initiation (<12 months, or <2 years)
- Outcome
- Early childhood caries (ECC)
In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded.
What each review found
Include earlier review versions| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years) Early childhood caries (presence/prevalence/severity by dmft/dmfs) · Healthy children under 6 years of age (6 months to 6 years); preschool children · Community/population-based; preschool children across Asia, Europe, North America, South America, Africa, and Australia (32 studies; 34,050 children), Primary analysis (all 10 studies) In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded. Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic… (2025) All outcomes | OR 1.40 [0.91, 2.16] | 10 studies · 23200 participants | GRADE not reported |
Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years) Early childhood caries (presence/prevalence/severity by dmft/dmfs) · Healthy children under 6 years of age (6 months to 6 years); preschool children · Community/population-based; preschool children across Asia, Europe, North America, South America, Africa, and Australia (32 studies; 34,050 children), Leave-one-out sensitivity analysis (Wagner 2017 outlier excluded, k=9) After excluding one outlier study (Wagner 2017), late brushing initiation was significantly associated with higher ECC odds (OR 1.75, 95% CI 1.50 to 2.03; I2=20.7%); ungraded. Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic… (2025) All outcomes | OR 1.75 [1.50, 2.03] | 9 studies | GRADE not reported |
Findings are shown side by side, never pooled across reviews.
The reviews
| Review | Searched up to | Included studies | AMSTAR 2 |
|---|---|---|---|
| Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic review and meta-analysis. 2025 All outcomes | January 2000 to August 2024 | 29 | Not applicable |
Studies behind the findings
The primary studies the full-text reviews tie to this outcome. Reviews with headline outcomes only do not list them here.
- Alhabdan 2018 · included by 1 of these review
- Skeie 2006 · included by 1 of these review
- Subramaniam 2012 · included by 1 of these review
- Sun X 2017 · included by 1 of these review
- Wagner 2014 · included by 1 of these review
- Wagner 2017 · included by 1 of these review
- Wigen 2018 · included by 1 of these review
How reviews are matched to this question
Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.