Knowledge, Attitude, and Behaviour Towards Fluoride Toothpaste Use and Toothbrushing Among 12-Year-Old School Children in Tawau District, Sabah

Introduction: Toothbrushing with fluoride toothpaste is the most acceptable and cost-effective way to prevent caries. Knowledge, attitude, and behaviour towards fluoride toothpaste use and toothbrushing are crucial for proper oral hygiene care among children. This study aims to assess the factors associated with toothpaste use and toothbrushing behaviour among 12-year-old children. Materials and methods: This cross-sectional study was conducted among 317 respondents of 12-year-old children in the Tawau district, Sabah. Respondents were chosen in equal numbers of females and males from the urban and rural areas by a non-proportionate stratified multistage random sampling method. The tool used was a self-reported, validated Malay-translated questionnaire. A Chi-square and Fisher’s exact tests assessed the association between variables of interest. Results: Most respondents had the misconception that fluoride's function was to make their teeth clean (n=147, 46.4%). Almost all respondents had a positive attitude towards the importance of brushing their teeth (n=314, 99.1%) and using toothpaste (n=311, 98.1%). 52.4% (n=166) of respondents brushed their teeth twice daily and 68.5% (n=217) used fluoridated toothpaste. For the post-toothbrushing behaviour, about 61.5% (n=195) of respondents very often rinse their mouth with water, but only 24.9% (n=79) used mouthwash products. Female (χ²=5.18, p=0.023), Bumiputera Sabah ethnicity (χ²=7.99, p=0.039), and urban school (χ²=5.80, p=0.016) were significantly associated with good toothpaste behaviour. Conclusion: As there was an association between sex, school location, and ethnicity with the behaviour of toothbrushing and toothpaste use, implementing preventive strategies based on effective evidence-based oral health education and promotion is needed to tackle these issues.