Changes in Toothbrushing Behaviors Following a Child Dental Care Reform in Israel

(1) Background: Toothbrushing behavior in children and adolescents is shaped
by national dental health policies and sociodemographic and psychological factors. In 2010,
child dental care was incorporated into Israel’s National Health Insurance Law (NHIL).
This study explored toothbrushing behavior and its predictors before and after this reform.
(2) Methods: Data from 36,755 students in grades 6–10 were analyzed from the Health
Behaviour in School-Aged Children study conducted pre-reform (1998, 2002, 2006) and
post-reform (2010, 2013, 2016). The dependent variable was toothbrushing behavior, while
the independent variables included sociodemographic and psychological characteristics.
Chi-squared tests compared proportions of compliant toothbrushing behaviors, and logistic
regression identified significant predictors. (3) Results: According to recommendations,
59–64% of children brushed their teeth before the reform. This proportion increased significantly
post-reform, reaching 73% in 2018. Predictors of compliance included being female,
younger, Jewish, and non-observant, having a higher socioeconomic status, and having a
better psychological status. These predictors were consistent in pre- and post-reform regression
models. (4) Conclusions: The dental care reform positively influenced toothbrushing
habits among children and adolescents. However, disparities remain among specific communities.
Interventions tailored to address sociodemographic and psychological factors
are recommended to enhance regular toothbrushing habits across all populations.