Toothpaste‐Related Attitudes and Practices of Parents of Preschool Children in Istanbul, Türkiye: A Cross‐Sectional Study

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Abstract
Objectives: To assess parental attitudes and practices regarding toothpaste usage in preschool children attending paediatric outpatient clinics in Istanbul, Türkiye, and to examine associations with socio‐demographic characteristics. Methods: A cross‐sectional questionnaire study was conducted among 203 parents of children under 6 years attending paediatric outpatient departments at two university hospitals in Istanbul (June 2022–February 2023). Toothpaste‐related items covered: whether toothpaste was used during brushing and how frequently; reasons for toothpaste usage; whether the child had a separate toothpaste; age at which toothpaste was introduced; who applied toothpaste; amount used; post‐brushing behaviour; criteria when choosing toothpaste; and reasons for brand selection. Chi‐square tests and Z tests with Bonferroni correction assessed associations with parent age, education, sex, number of children and child age group. Results: The majority of children (84.2%) were reported to use toothpaste during toothbrushing, while only 71.4% used it every time. Only 12.3% of parents started using toothpaste immediately after eruption of the first deciduous teeth, while 70.2% began between ages 1–3 years. More than half of parents (59.1%) put toothpaste on their children’s toothbrush themselves, and 64.9% used less than 1/3 of the brush length. However, 22.4% of children swallowed toothpaste while brushing, significantly more common in children under 2 years (61.5%) and in single‐child families (32.9% vs. 11.1%; p = 0.020). Consistent toothpaste usage was significantly associated with child age ( p < 0.001) and parent age ( p < 0.001). Most parents (87.1%) considered the contents of toothpaste when choosing, while only 8.8% specifically mentioned fluoride. Nearly half (47.6%) chose their toothpaste brand due to organic/herbal ingredients, and the most popular brand chosen was a fluoride‐free product (29.9%). Conclusions: Despite high overall rates of toothpaste usage, important gaps remain: delayed introduction, high rates of toothpaste swallowing among young children and critically low awareness of fluoride as a key toothpaste ingredient. Targeted parental education, particularly on the benefits of fluoridated toothpaste, appropriate quantity and correct post‐brushing behaviour, is urgently needed.

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