Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day): Early childhood caries (ECC)
- Population
- Healthy children under 6 years of age (6 months to 6 years); preschool children
- Intervention
- Low tooth brushing frequency (<2 times/day)
- Comparison
- High tooth brushing frequency (>=2 times/day)
- Outcome
- Early childhood caries (ECC)
After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded.
What each review found
Include earlier review versions| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day) 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 (Alhabdan 2018 outlier excluded, k=7) After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded. Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic… (2025) All outcomes | OR ~2.0 | 7 studies | GRADE not reported |
Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day) 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 8 studies) Brushing less than twice daily was associated with about 2.1-fold higher odds of early childhood caries (OR 2.11, 95% CI 1.25 to 3.55), with very high heterogeneity (I2=93.36%); ungraded. Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic… (2025) All outcomes | OR 2.11 [1.25, 3.55] | 8 studies · 14981 participants | 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.
- Chouchene 2022 · included by 1 of these review
- Peres 2005 · 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.