Factors influencing parents’ choices of oral care products for children

Authors

Abstract

Aim This study aimed to evaluate the factors influencing parents’ choices of oral care products for their children.
Materials and Methods A cross-sectional descriptive study was conducted in the Department of Pediatric Dentistry, Altınbaş University, between April and June 2023. Ethical approval was obtained (No: 2023/186). A structured 15-item questionnaire was administered to parents of children aged 4–9 years. A total of 552 valid responses were analyzed using Pearson Chi-Square tests (IBM SPSS 25), with significance set at p < 0.05.
Results The study included 552 parents (21% male, 79% female; mean age 36.91 ± 5.79 years). Pediatric dentists (52.7%) and dentists (37.3%) were reported as the main sources of information for product selection. While 59.6% of parents recognized fluoride as caries-preventive, 40.4% held misconceptions regarding its potential health risks. Mothers were significantly more likely than fathers to consider “chemical content” when selecting toothpaste (p < 0.05). Higher educational status was significantly associated with increased attention to “fluoride concentration,” “chemical content,” and “child’s age” (p < 0.01). In toothbrush selection, mothers emphasized brush head, bristle type, electric use, and child’s age more than fathers (p < 0.05). Parents with university-level education reported greater emphasis on toothbrush features and dentist recommendations (p < 0.01).
Discussion Parental gender, education, and socioeconomic status significantly influenced oral care product choices. Although professional guidance played a strong role in decision-making, misconceptions regarding fluoride and sodium lauryl sulfate persisted. These findings highlight the importance of targeted parental education and professional counseling to support informed product selection and promote optimal oral health in children.

Keywords

Introduction

Childhood is a critical period for establishing oral health behaviors that lay the foundation for lifelong oral well-being. Appropriate oral hygiene practices adopted during this stage are essential for preventing dental caries and periodontal diseases [1]. Parents, as primary caregivers, play a central role in fostering these habits, particularly during the first three years of life, when they are chiefly responsible for their children’s oral health [2, 3]. This responsibility continues throughout the preschool years, when sustained parental involvement remains vital for promoting and maintaining optimal oral health [3]. Parents play a crucial role not only in instilling oral hygiene habits in their children but also in selecting appropriate oral care products, serving as the primary decision-makers in this regard [4].
Since the dental industry is growing daily, there are many different kinds of oral care products on the market, such as toothbrushes, toothpaste, mouthwash, and dental floss, among which toothbrushes and toothpastes are the most widely used [5]. Making the right choice in oral care products is crucial to maintaining good oral health. However, individuals find it challenging to choose due to the variety of oral and dental care products available and the abundance of eye-catching ads for these items [6].
Purchasing decisions for oral care products are shaped by a range of influences, including environmental, familial, and sales-related factors, as well as cultural, social, personal, and psychological considerations [7]. Consumer behavior refers to the decision-making process by which individuals determine why, when, and how to purchase a necessary product from among various available options [8]. Therefore, it is important to understand what factors parents consider when choosing oral care products for their children. The aim of the present study is to evaluate the factors that influence parents’ choices of children’s oral care products.

Materials and Methods

This cross-sectional and descriptive study was conducted at the Department of Pediatric Dentistry, Faculty of Dentistry, Altınbaş University, between April and June 2023. The sample size was calculated using a 50% prevalence rate, a 5% error, and a 95% confidence interval, resulting in a minimum sample size of 384 parents. The study sample consisted of parents who had children aged 4–9 years, provided informed consent to participate, and completed all questionnaires in their entirety. A total of 582 parents participated in the survey; however, 30 questionnaires were excluded because of incomplete responses, resulting in 552 surveys being included in the final analysis.
The researcher (S.D.) developed a structured questionnaire to collect data on parents’ choices for oral care products. The survey has 15 questions in all, divided into two sections. The first section comprised questions on parents’ sociodemographic characteristics, dental care routines, and sources of information regarding their children’s oral care products, while the second section focused on factors influencing parents’ selection of these products.
Statistical Analysis
IBM SPSS Statistics 25 software (Chicago, USA) was used for statistical analysis. Study data were analyzed using descriptive statistical methods, including mean, standard deviation, median, minimum, and maximum values. Pearson Chi-Square tests were used for comparisons between variables. Statistical significance was assessed at the p < 0.01 and p < 0.05 levels.
Ethical Approval
This study was approved by the Clinical Research Ethical Committee of Altınbaş University (Date: 2023-04-14, No: 2023/186).

Results

Our study was conducted with the participation of a total of 552 parents, including 116 males (21%) and 436 females (79%). The gender distribution of the parents indicated that 21.0% (n = 116) were male and 79.0% (n = 436) were female. Regarding educational status, 28.8% (n = 159) had completed primary school, 19.2% (n = 106) secondary school, 34.4% (n = 190) high school, and 17.6% (n = 97) university education. In terms of income levels, 9.1% (n = 50) reported earning below the minimum wage, 49.3% (n = 272) at the minimum wage, and 41.7% (n = 230) above the minimum wage. The ages of the parents ranged from 25 to 63 years, with a mean age of 36.91 ± 5.79 years.
The sources from which parents obtain information when selecting oral care products for their children are presented in Figure 1. Factors influencing parents’ choice of toothpaste and toothbrush are shown in Figure 2. In Figure 3, while 59.6% of parents indicated that fluoride is an agent that prevents
dental caries, 40.4% stated that it may cause mental and developmental retardation. Regarding sodium lauryl sulfate, 80.3% of parents indicated that it functions as an agent that enhances the cleaning efficacy of toothpaste, whereas 19.3% reported that it may adversely affect oral tissues.
Based on parental gender, mothers obtain information about oral care products from pediatric dentists and television at a statistically significantly higher rate compared to fathers. Among parents with a university education, the rate of reporting a medical doctor as a source of information regarding the selection of oral care products was statistically significantly higher. Parents with high school and university education were statistically more likely to report social media as a source of information for choosing oral care products (Table 1). Mothers were significantly more likely than fathers to consider ‘chemical content’ as an influencing factor when selecting toothpaste for their children (p = 0.019; p < 0.05). Parental education level was significantly associated with the consideration of ‘fluoride content’, ‘chemical content’, and the child’s age when selecting toothpaste for their children (p = 0.001; p < 0.01), with higher rates reported among parents with high school or university education (Table 2). According to parental gender distribution, statistically significant diffrences were observed in the responses to the question ‘Which factors influence your choice of toothbrush for your child?’ with mothers reporting ‘brush head’ (p = 0.040; p < 0.05), ‘bristle type’ (p = 0.003; p < 0.01), ‘electric’ (p = 0.040; p < 0.05), and ‘child’s age’ (p = 0.021; p < 0.05) more frequently than fathers. Considering parental educational status, the response rates of ‘toothbrush head,’ ‘bristle type,’ ‘electric,’ and ‘child’s age’ as factors influencing the choice of toothbrush for their child showed statistically significant differences (p = 0.001; p < 0.01), with higher rates observed among parents with a university education Table 3.

Discussion

The importance parents attribute to oral and dental health, together with their knowledge, attitudes, and behaviors, constitutes a determining factor in the formation of children’s oral hygiene practices [9]. Although a wide variety of oral care products for children are commercially available, it is of considerable importance that parents make informed choices regarding the most appropriate products for their children [6]. This study investigated the determinants influencing parents’ decision-making when selecting oral hygiene products for their children.
In our study, when the sources from which parents obtained information regarding the selection of oral care products for their children were evaluated, the majority reported receiving information primarily from pediatric dentists (52.7%) and dentists (37.3%). In the study conducted by Ak et al., the most frequently reported sources of information regarding toothpaste were social media and dentists [10]. In contrast, according to the findings of Pawar and Ghewari, television and advertisements were identified as the most influential sources guiding parents in the selection of oral care products [11].
The study revealed that 59.6% of parents recognized fluoride as a caries-preventive agent. Consistent with our findings, previous studies have widely demonstrated that fluoride is effective in the prevention of dental caries [12, 13, 14]. Sodium lauryl sulfate (SLS) is currently the most commonly used surfactant in toothpaste formulations. SLS has been reported to exert antimicrobial activity by penetrating bacterial cell walls [15]. Despite these beneficial properties, several toxic effects of SLS have also been documented. Clinical studies have demonstrated that SLS can cause epithelial damage, ulceration, and inflammation in the oral mucosa [16]. It has further been shown that SLS penetrates into deeper layers of the mucosa, disrupts the mucin layer, induces denaturation of epithelial cell proteins, increases the solubility of structural lipids, and ultimately impairs the function of living tissue [16, 17, 18]. In our study, 80.3% of parents reported that SLS is a beneficial agent that enhances the cleaning efficacy of toothpaste; however, this reflects a misconception.
In our study, the most influential criteria for parents when choosing toothpaste for their children were “brand” (37.7%) and “dentist’s recommendation” (37.5%). In contrast, Egil et al. (2020) reported that the most important factors influencing parents’ choice of children’s toothpaste were “caries-preventive properties” and “well-known brand” [19]. Similarly, in a study by Jahandideh and Tüloğlu, which evaluated parents’ knowledge regarding preventive practices in oral and dental health, the most valued criteria for selecting toothpaste for children aged 0–13 years were “dentist’s recommendation” and “fluoride content” [20]. Previous study demonstrated that parents prioritized “dentist’s recommendation” and “toothpaste flavor” in their selection process [14]. Pawar and Ghewari reported that “brand” and “flavor” were the most important factors influencing parents’ choices of oral care products for their children [11]. Our findings further indicated that as parents’ socioeconomic status increased, greater importance was placed on “brand,” “fluoride concentration,” “toothpaste flavor,” and “chemical content” when selecting toothpaste for their children. Moreover, higher parental education levels were associated with increased emphasis on “fluoride concentration,” “chemical content,” and “child’s age” as determining factors. Additionally, our study revealed that mothers gave greater consideration to the “chemical content” of toothpaste compared to fathers.
In our study, the most important criteria reported by parents when selecting a toothbrush were the child’s age and the dentist’s recommendation. In the study conducted by Şenocak et al., dentist recommendation was identified as the most influential factor in product selection (85.9%), and 77.4% of parents considered it to be very important [5]. Similarly, Eğil et al. reported that dentist recommendations played a role in pediatric toothpaste selection for 21.4% of parents [19]. Consistently, Opeodu et al. found that approximately 51% of participants selected their toothbrushes based on a dentist’s recommendation [21]. According to our findings, female parents with a university-level education placed greater emphasis on factors such as the toothbrush head, bristle type, the use of an electric toothbrush, and the child’s age when choosing a toothbrush. Furthermore, our study indicates that as the income level of parents increases, criteria such as price, toothbrush head, bristle type, color, use of an electric toothbrush, and the child’s age become more prominent in their decision-making process.
Our study has several limitations. The proportion of female parents (79%) was higher than that of male parents (21%), resulting in a lack of homogeneity in the parental gender distribution. Surveys were administered to 552 parents in this study. Future studies with larger sample sizes are important for enhancing the reliability of the research. Additionally, the subjective nature of the responses provided by parents may have influenced the findings and, consequently, the results of our study.

Limitations

This study has several limitations that should be acknowledged. First, the gender distribution of the participants was not balanced, with a predominance of mothers (79%) compared to fathers (21%), which may have introduced bias in reflecting parental perspectives. Second, the study was based on a self- reported questionnaire, and the subjective nature of parental responses may have led to recall bias or socially desirable answers. Third, the study was conducted at a single university clinic, which may limit the generalizability of the findings to broader populations with different socioeconomic, cultural, and geographic characteristics. Fourth, although the sample size was sufficient for statistical analysis, the cross-sectional design prevents establishing causal relationships between sociodemographic factors and parents’ choices of oral care products.

Conclusion

The findings of this study highlight the pivotal role parents play in shaping their children’s oral health habits and in selecting appropriate oral care products. Pediatric dentists and dentists emerged as the primary sources of information, emphasizing the influence of professional guidance on parental decision- making. Socioeconomic factors, educational levels, and parental gender significantly influenced the criteria used for selecting toothpaste and toothbrushes, including considerations such as chemical content, fluoride concentration, child’s age, and product features. Mothers, particularly those with higher education, demonstrated greater attention to specific product attributes compared to fathers.
Overall, this study underscores the importance of targeted oral health education for parents to enhance informed decision- making and ensure optimal oral care for children. Dental professionals should actively provide evidence-based guidance to address misconceptions and support parents in selecting safe and effective products. Future research with larger and more diverse samples is warranted to further explore parental behaviors and preferences, and to develop strategies that promote consistent and informed oral hygiene practices across different populations.

References

1. Abanto J, Oliveira LB, Paiva SM, Guarnizo-Herreño C, Sampaio FC, Bönecker M. Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach. Braz Oral Res. 2022;36:e113.
   PubMed Google Scholar
2. Duijster D, de Jong-Lenters M, Verrips E, van Loveren C. Establishing oral health promoting behaviours in children: parents’ views on barriers, facilitators and professional support: a qualitative study. BMC Oral Health. 2015;15:157.
   PubMed Google Scholar
3. Bozorgmehr E, Hajizamani A, Malek Mohammadi T. Oral health behavior of parents as a predictor of oral health status of their children. ISRN Dent. 2013;2013:741783.
   PubMed Google Scholar
4. Saldūnaitė K, Bendoraitienė EA, Slabšinskienė E, Vasiliauskienė I, Andruškevičienė V, Zūbienė J. The role of parental education and socioeconomic status in dental caries prevention among Lithuanian children. Medicina (Kaunas). 2014;50(3):156-61.
   PubMed Google Scholar
5. Şenocak H, Tüzüner T, Renda G, Korkmaz B, Çoban Ö. Ebeveynlerin çocuklarının kullandıkları ağız ve diş sağlığı bakım ürünlerini seçme kriterlerleri ve ilişkili faktörlerin değerlendirilmesi [Evaluation of parents’ selection criteria and related factors of oral and dental health care products used by their children]. Farabi Tıp Derg. 2023;2(4):7-16.
   PubMed Google Scholar
6. Agrawal A, Gupta A. Exploring the factors influencing the choice of oral care products: a review on personalized approach. Int J Oral Dent Health. 2020;6(2):10- 23937.
   PubMed Google Scholar
7. Awais F, Bin Shahzad H, Naheed K, Ali Khan A. Factors influencing consumers’ choices of oral hygiene products: a cross-sectional study. J Pak Dent Assoc. 2019;28(2):85-90.
   PubMed Google Scholar
8. Vani G, Babu MG, Panchanatham N. Toothpaste brands: a study of consumer behavior in Bangalore city. J Econ Behav Stud. 2010;1(1):273-9.
   PubMed Google Scholar
9. Gibson S, Williams S. Dental caries in pre–school children: associations with social class, toothbrushing habit and consumption of sugars and sugar- containing foods. Further analysis of data from the National Diet and Nutrition Survey of children aged 1.5-4.5 years. Caries Res. 1999;33(2):101-13.
   PubMed Google Scholar
10. Ak AT, Aksoy H, Özdaş DÖ. Türk ailelerinin florlu diş macunu ve topikal flor uygulamaları hakkında bilgi ve görüşlerinin değerlendirilmesi: pilot çalışma. [Evaluation of Turkish parents’ knowledge and opinions about fluoride toothpaste and topical fluoride applications: a pilot]. Ege Üniv Diş Hekim Fak Derg. 2018;39(3):160-4.
    PubMed Google Scholar
11. Pawar SN, Ghewari AA. A study of factors responsible for choice of FMCG products (dental care products). Int J Res Appl Sci Eng Technol. 2022;10(11):1320- 7.
    PubMed Google Scholar
12. Sogi HS, Hugar SM, Nalawade TM, Sinha A, Hugar S, Mallikarjuna RM. Knowledge, attitude, and practices of oral health care in prevention of early childhood caries among parents of children in Belagavi city: a questionnaire study. J Family Med Prim Care. 2016;5(2):286-90.
    PubMed Google Scholar
13. Mani SA, John J, Ping WY, Ismail NM. Early childhood caries: parents’ knowledge, attitude and practice towards its prevention in Malaysia. Oral Health Care Pediatr Res Epidemiol Clin Pract. 2012;1:1-18.
    PubMed Google Scholar
14. Liu M, Zhu L, Zhang B, Petersen PE. Changing use and knowledge of fluoride toothpaste by schoolchildren, parents and schoolteachers in Beijing, China. Int Dent J. 2007;57(3):187-94.
    PubMed Google Scholar
15. Joiner A, Schwarz A, Philpotts CJ, Cox TF, Huber K, Hannig M. The protective nature of pellicle towards toothpaste abrasion on enamel and dentine. J Dent. 2008;36(5):360-8.
    PubMed Google Scholar
16. Macdonald JB, Tobin CA, Hurley MY. Oral leukoedema with mucosal desquamation caused by toothpaste containing sodium lauryl sulfate. Cutis. 2016;97(1):E4-E5.
    PubMed Google Scholar
17. Siegel IA, Gordon HP. Surfactant-induced alterations of permeability of rabbit oral mucosa in vitro. Exp Mol Pathol. 1986;44(2):132-7.
    PubMed Google Scholar
18. Healy CM, Paterson M, Joyston‐Bechal S, Williams DM, Thornhill MH. The effect of a sodium lauryl sulfate‐free dentifrice on patients with recurrent oral ulceration. Oral Dis. 1999;5(1):39-43.
    PubMed Google Scholar
19. Egil E, Duman C, Karaca S, Acar Ezberci S, Yılmaz DÖ, Tabakçılar Dündar D. Ebeveynlerin çocuk diş macunu seçimini etkileyen faktörlerin değerlendirilmesi. [Evaluation of the factors affecting parents’ children toothpaste]. Turk J Pediatr Dent. 2020;1(2):45-52.
    PubMed Google Scholar
20. Jahandideh A, Tüloğlu N. Ebeveynlerin ağız-diş sağlığındaki koruyucu uygulamalar hakkındaki bilgilerinin değerlendirilmesi. [Evaluation of parental knowledge about preventive applications in oral and dental health]. Suleyman Demirel Univ Saglik Bilim Derg. 2019;10(4):403-12.
    PubMed Google Scholar
21. Opeodu OI, Gbadebo SO. Factors influencing choice of oral hygiene products by dental patients in a Nigerian teaching hospital. Ann Ibadan Postgrad Med. 2017;15(1):51-6.
    PubMed Google Scholar

Declarations

Additional Information

Publisher’s Note
Bayrakol MP remains neutral with regard to jurisdictional and institutional claims.

Rights and Permissions

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). To view a copy of the license, visit https://creativecommons.org/licenses/by-nc/4.0/

View full license details →

About This Article