Oral Hygiene Practices and Use of Preventive Dental Products Among Six-Year-Old Children at School Entry: A Cross-Sectional Study

Background Appropriate oral hygiene practices established in early childhood are essential for preventing dental caries. Parental awareness and supervision during the early school years play a key role in the development of effective daily oral hygiene habits. However, data on oral hygiene practices and the use of preventive dental products among children at school entry remain limited in many primary healthcare settings. Materials and methods This cross-sectional study included 307 six-year-old children who attended routine school-entry dental examinations at the Department of Dentistry, Public Health Institution "Health Center" Živinice, Bosnia and Herzegovina, between September 2022 and September 2024. Parents completed a structured questionnaire on the timing of the child’s first dental visit, initiation of toothbrushing, caregiver involvement in daily oral hygiene, and use of mechanical and chemical oral hygiene products. Categorical variables were summarized using descriptive statistics, and differences in questionnaire responses were analyzed using the Pearson Chi-square (χ²) test, with a significance level of p < 0.05. Results Delayed initiation of the first dental visit and toothbrushing were commonly reported. Only a minority of children attended their first dental visit following eruption of the first tooth, while most began brushing after eruption of several primary teeth. Parental supervision of oral hygiene was inconsistent, and independent brushing from the beginning was reported in a subset of children. Although regular toothbrush and toothpaste use was nearly universal, the use of adjunctive preventive products was limited, and more than half of parents were unaware of the fluoride content of their children's toothpaste. Conclusion Oral hygiene practices among six-year-old children appear suboptimal, with delayed initiation of preventive care and limited parental awareness of fluoride use. Educational interventions aimed at improving caregiver knowledge and supervision of children’s oral hygiene practices may support the development of more effective preventive behaviors at school entry.