At what age do children have the motor development to adequately brush their teeth?

BACKGROUND: There is no consensus regarding when children are ready to brush independently. AIM: To examine the effects of chronological age and motor development on toothbrushing effectiveness in 5- to 7-year-old children. DESIGN: In this cross-sectional study, the change in Oral Hygiene Index (OHI) score and the improvement in OHI category (eg, poor to fair) were used to measure toothbrushing effectiveness. Motor development was assessed using the Beery-Buktenica Developmental Test of Visual Motor Integration, and a parental questionnaire was used to determine the child's ability to perform certain daily tasks. RESULTS: Children aged ≥6 years were significantly more likely to show improvement in OHI category (OR = 2.4, p = .032) than 5-year-old children. Parental report of their child's ability to write/print addresses (OR = 3.7, p = .009), tie shoelaces (OR = 2.9, p = .008), and cut/file nails (OR = 3.2, p = .036) was significantly more likely to show improvement in OHI category. A model using chronological age, visual motor age, ability to write/print addresses, tie shoelaces, cut/file nails, and toothbrushing duration achieved 61.8% sensitivity and 80.4% specificity in predicting a child's ability to achieve improvement in OHI category. CONCLUSIONS: Children entering elementary school (≥6 years old) brushed their teeth more effectively than preschool children. A multifactorial model provided an acceptable predictor of the child's ability to brush effectively.