The effectiveness of the Brush Day and Night programme in improving children's toothbrushing knowledge and behaviour

Int Dent J. 2018 May;68 Suppl 1:7-16. doi: 10.1111/idj.12410. Epub 2018 Apr 16.


Background: Regular twice-daily toothbrushing with a fluoridated toothpaste is widely recommended for schoolchildren. The '21-day Brush Day and Night (BDN) programme' includes an educational approach for children and school staff, with a consistent practice of toothbrushing at school for 3 weeks.

Objective: This study aims to evaluate the improvement in oral hygiene knowledge and behaviour in schoolchildren involved in BDN, the sustainability of this after 6-12 months, and if any particular age group was more receptive to it than others.

Materials and methods: Ten countries and 7,991 children, 2-12 years old, participated in this longitudinal study, with two BDN interventions at the beginning and 6-12 months afterward. Data were collected via a self-reported questionnaire at baseline/first intervention (T0), 21 days after first intervention (T0D21), at the second intervention (T1), and 21 days after second intervention (T1D21). Improvement in knowledge and behaviour was compared using the chi-square test with an alpha level of 5%. The final data sample of 5,148 schoolchildren was evaluated, and the analysis revealed that 25% more of the schoolchildren brushed their teeth twice a day after the first intervention. The programme was more effective among the 7-9 years age group. The BDN intervention increased brushing-frequency in children at the first intervention, and this was sustained after 6-12 months. Therefore, this programme illustrated a sustainable approach to improve children's oral health knowledge and behaviour.

Keywords: 21-day programme; Oral health school programme; knowledge; oral health behavior; schoolchildren; toothbrushing.

MeSH terms

  • Age Factors
  • Child
  • Child, Preschool
  • Female
  • Global Health
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Oral Health / education
  • Program Evaluation
  • School Health Services* / organization & administration
  • Toothbrushing* / statistics & numerical data