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Preventive

404 - Exploring Flossing Behaviors, Barriers, and Facilitators in Young Children

Saturday, May 23, 2026
2:45 PM - 3:00 PM PST
Has Audio

    Presenting Author(s)

  • Malik N. Walters, DDS, MS

    Resident
    University of Illinois Chicago
    University of Illinois Chicago
    Chicago, Illinois, United States

    • Co-Author(s)

  • David M. Avenetti, DDS (he/him/his)

    Pediatric Dentistry Department Head, Clinical Associate Professor
    University of Illinois Chicago
    University of Illinois Chicago, Dept. of Pediatric Dentistry
    Chicago, Illinois, United States

  • GC

    Geisel Collazo, MD

    University of Illinois at Chicago

  • Bhakti K. Desai, DMD

    Pediatric Dental Resident, PGY-2
    University of Illinois Chicago
    University of Illinois-Chicago, Chicago IL
    Chicago, Illinois, United States

  • Brittaney J. Hill, DDS

    Clinical Associate Professor and Residency Program Director
    University of Illinois Chicago
    University of Illinois at Chicago
    Chicago, Illinois, United States

  • Lisa Rawle, BDS, MS, MPH

    Clinical Assistant Professor Pediatric Dentistry
    University of Illinois Chicago
    University of Illinois at Chicago
    Chicago, Illinois, United States

    • Research Mentor(s)

  • David M. Avenetti, DDS (he/him/his)

    Pediatric Dentistry Department Head, Clinical Associate Professor
    University of Illinois Chicago
    University of Illinois Chicago, Dept. of Pediatric Dentistry
    Chicago, Illinois, United States

    • Program Director(s)

  • Brittaney J. Hill, DDS

    Clinical Associate Professor and Residency Program Director
    University of Illinois Chicago
    University of Illinois at Chicago
    Chicago, Illinois, United States

Abstract:

Purpose: Regular flossing is recommended to reduce caries risk, yet evidence of its effectiveness in young children is limited. This study assessed flossing frequency among pediatric patients, identified demographic/socioeconomic factors associated with flossing, and evaluated caregiver-perceived barriers and facilitators and their association with flossing.

Methods: This cross-sectional survey included adult English-speaking caregivers of children ages 2–7 years, recruited from three dental clinics (one university-based clinic and two private practices) serving privately- and publicly-insured patients. Caregivers completed an electronic Qualtrics survey. The primary outcome was child flossing frequency. Spearman correlations, Kruskal-Wallis tests, and ordinal regression were conducted.

Results: 101 of 113 surveys were analyzed. Caregivers were 88% female, 52% White/Caucasian, and 30% Hispanic; 60% held a bachelor's degree or higher. Children were a mean of 5.33+1.6 years with 36% experiencing at least one cavity. While 90% of children brushed daily, only 24% were flossed daily, and 19% never flossed. Caregiver flossing frequency (r=0.399, p<0.001) and caregiver assistance with flossing (r=0.356, p<0.001) were the strongest positive predictors of child flossing frequency. Race/ethnicity was the only demographic variable significantly associated with flossing (p=0.044). In ordinal regression, 13 of 15 factors were significantly associated with child flossing frequency, with the strongest predictors of lower flossing frequency being: believing ‘flossing would not help’ (OR=0.40), caregiver ‘being too busy’ (OR=0.48), and family schedule ‘being too busy’ (OR=0.48), all p<0.001.

Conclusions: Identifying barriers and caregiver characteristics associated with low flossing frequency may inform targeted interventions to increase flossing and reduce caries risk in pediatric populations.

Identify Supporting Agency and Grant Number: Research supported by UIC Department of Pediatric Dentistry