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Year : 2017  |  Volume : 15  |  Issue : 4  |  Page : 388-391

Factors influencing selection of manual toothbrush among an urban population in Chennai City, India: A cross-sectional study

Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Web Publication13-Dec-2017

Correspondence Address:
Dr. Arthi Balasubramaniam
Department of Public Health Dentistry, 2/102, East Coast Road, Uthandi, Chennai - 600 119, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jiaphd.jiaphd_49_17

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Introduction: Toothbrush and toothpaste remain the mainstay of oral health measure. There are numerous factors that influence the choice of consumers to trade their toothbrush. Actual factors relating the use and purchase of manual toothbrush among consumers are under research. Aim: The aim of the study was to determine the attributes that influence the selection of manual toothbrush among an urban population to maintain their oral health. Materials and Methods: This survey was carried out among 1000 participants aged 18 or above and those who visited business malls, departmental stores, and cooperative society stores in Chennai city using a self-administered questionnaire. The questionnaire comprised of questions related to the various aspects of manual toothbrush head, bristle, handle, price, color, bristle texture, brand, etc. along with toothbrush brand with multiple choices at which the consumers wished to trade. Descriptive statistics and multinomial logistic regression were used. Results: The average age of the participants was 37.48 ± 14.85 years. Participants with higher education, professional employment, and with higher income had higher odds of selecting the conventional designed, diamond headed manual toothbrush, with slip prevention handle and preferred them purchasing at price of greater than Rs. 40. Conclusion: The study results point out the role of education, occupation, and income of consumers playing an important role in selecting the toothbrush of their choice.

Keywords: Factors, manual toothbrushing, selection, urban population

How to cite this article:
Balasubramaniam A, Parangimalar Diwakar MK, Brinda B. Factors influencing selection of manual toothbrush among an urban population in Chennai City, India: A cross-sectional study. J Indian Assoc Public Health Dent 2017;15:388-91

How to cite this URL:
Balasubramaniam A, Parangimalar Diwakar MK, Brinda B. Factors influencing selection of manual toothbrush among an urban population in Chennai City, India: A cross-sectional study. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2024 Mar 4];15:388-91. Available from: https://journals.lww.com/aphd/pages/default.aspx/text.asp?2017/15/4/388/220713

  Introduction Top

Toothbrushing remains the mainstay of oral health measure in the world, coupled with the widespread use of fluoride toothpaste.[1] Globally, out of 6 billion people, 4.2 billion people own a toothbrush with an average cost of each toothbrush being $1. A survey conducted among US households in 2015, reported that 83.32% of them use a manual toothbrush.[2] The toothbrush market in India has also been increasing at an exponential annual growth of 6.4% between 2004 and 2009 which is being expected to increase to 13.9% between 2014 and 2018.[3]

There are numerous factors in the toothbrush which influence the choice of consumers to trade then. The actual factors relating the use and purchase of manual toothbrush among consumers are under research. Literature says that the perception of choice of a product depends on consumers' behavior influenced by cultural, social, family, scale person, personal, and psychological factors. The personal factors, in turn, depend in decision-making of risk aversion, innovativeness, product class knowledge, quality, packaging, promotion, familiarity with a channel, brand awareness, family influence, professional influence, and shopping motives.[4]

Studies have reported that a consumers' choice of manual toothbrush depended on the appropriate handle size of user's age and dexterity and also their appropriate head size to the user's mouth.[5] In addition, the properties such as flexibility and filament morphology also considered in purchasing the manual toothbrush. In a study conducted by Kote et al., among student population in India, the importance of bristle design and bristle consistency were reported as primary factors influencing their choice for manual toothbrush.[6]

Although studies have concentrated on single factor influencing the choice of manual toothbrush among consumers, variety of factors influencing the choice of manual toothbrush along with education, occupation, and income has not ever recorded in the literature.[7] This assumes importance as this information not only helps us to predict the factors influencing the choice of toothbrush but also provides an indirect indicator of oral health behavior of the consumers.

This survey was designed to determine various factors including properties of manual toothbrush (head design, bristle design, handle design, and bristle texture), price, color, brand of toothbrush, education, occupation, and income influence the selection of manual toothbrush among Indian consumers. The implications of this survey can be used not only as an indirect predictor of individual's perception in selecting their manual toothbrush but also throw light on oral health knowledge and literacy of the general population.

  Materials and Methods Top

This survey was carried out among consumers of manual toothbrush in Chennai district, Tamil Nadu, India. Ethical clearance was granted by the Institutional Review Board. Informed consent was obtained from all participants who expressed their willingness to participate in this study.

This survey was conducted among a total of 1000 participants from the month of January 2016 to March 2016. A convenience sampling method was used to select the study participants. The inclusion criteria for selecting the participant included age 18 years or older, use of manual toothbrush to clean their teeth, who select toothbrush for themselves, and have a minimum of twenty natural teeth.

Data were collected using pretested questionnaire which was administered by a single interviewer. The questionnaire was framed using the various aspects of manual toothbrush head, bristle, handle, price, color, bristle texture, and brand types available in the Indian market both in English and vernacular language (Tamil). This questionnaire was pilot tested among a group of study participants to check its comprehensibility. Necessary modifications were done in the final questionnaire.

The study questionnaire in addition to information about personal details (education, occupation, and income), from modified Kuppuswamy socioeconomic scale,[8] dichotomized for statistical analysis. Participants with minimum education of middle school were considered as educated and with a minimum occupation of skilled worker were considered as professional. Various characteristics of manual toothbrush such as toothbrush head design (conventional, diamond, and others), toothbrush bristle design (block, wavy, and Crisscross), toothbrush handle design (Contra-angled, flexible, slip prevention), price of the toothbrush (Rs. <40 and Rs. >40), color of the toothbrush (green, blue, red, and others), texture of the toothbrush bristle (soft, medium, and hard), and toothbrush brand (Colgate, Oral B, and Pepsodent) which were available in the Indian market.

The survey sites from north, south, and east zone of Chennai city were selected conveniently. The questionnaire was distributed to the participants at the entrance of business malls, departmental stores, and cooperative society stores with an intention not to disturb their trading. The business malls, departmental stores, and cooperative society stores were selected to collect the information, as people of different socioeconomic status visit these places.

The questionnaire containing the study information was filled out by the participants after complete explanation of the purpose of the survey to the participants. A schedule was prepared to conduct the survey on all weekend days. The self-administered questionnaire was distributed to 70–100 participants per day and the time taken to fill the questionnaire by a person was approximately 5–7 min. The pro forma was collected immediately after being filled by the participants.

The collected data were entered in the Microsoft Excel sheet, 2013. The entered data were statistically analyzed using Statistical Package for the Social Sciences version 20 (IBM Corp. IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp). Descriptive statistics such as percentages and frequencies were analyzed. Multinomial logistic regression was done to determine the influence of education, occupation, and income on the selection of various characteristics of manual toothbrush.

  Results Top

A total of 1000 people visiting the business malls, departmental stores, and cooperative stores in Chennai participated in the study. [Table 1] shows the average age of the study participants 37.48 years (standard deviation = 14.85) with a range of 18–85 years. Distribution of gender among the study participants was 56.2% of males and 43.8% of females. Multinomial logistic regression model fits good to the study with statistically significant likelihood ratio (P< 0.05).
Table 1: Distribution of study participants based on sociodemographic variables

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[Table 2] the multinomial logistic regression showed that compared to various designs of manual toothbrush, educated, professionally employed participants with a family income above Rs. 13,873 had higher odds in selecting conventional designed, diamond headed toothbrush (3.5 95% confidence interval [CI] [1.23–9.96] P = 0.01) with slip prevention handled toothbrush (1.6 95% CI [1.13–2.38] P = 0.00) and preferred them purchasing at price above Rs. 40 (1.5 95% CI [0.88–2.57] P = 0.00). Regarding the selection of color of the toothbrush and toothbrush brand, similar participants had higher odds in selecting blue (1.5 95% CI [0.88–2.25] P = 0.001) and Colgate branded toothbrush (2.8 95% CI [1.31–5.98] P = 0.002).
Table 2: Multinomial logistic regression for sociodemographic variables and various manual toothbrushes attributes

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  Discussion Top

The goal of toothbrushing is to break up and disturb dental plaque biofilm. This process helps to keep the age of the plaque relatively young and therefore inhabited by less harmful bacteria rather than the pathogenic bacteria.[9] To fulfill this goal, the toothbrush should have an essential design of being able to be adapted to all surfaces of tooth (facial, lingual, occlusal, and proximal) to generate effective cleaning motion and produce no deleterious effects on hard and soft tissues.[10]

Toothbrushes in the market today, with their own special design features of handle, head, filament, very well reflects people's understanding of the requirements of effective toothbrushes and great potential of toothbrush to fulfill the goal.[11] Hence, it is important to know the factors which influence the preference of customers to trade their manual toothbrush. To the best of our knowledge, this was the first study to include various aspects of manual toothbrush head, bristle, handle, color, and brand preference with multiple choices available in the Indian market.

A study reported that an individual's preference and perception in selection of a manual toothbrush were determined by his or her financial situation, education, personality, and attitude to the oral health.[12] The sociodemographic variable was found to have a potential effect on the various factors of manual toothbrush under consideration in this study. Thus, the importance of these variables could play a role in determining the factors in the selection of manual toothbrush which reflects the knowledge, attitude, and perception of people among general population.

The findings of this study are similar to the study by Karve,[13] in which 82.9% of the population gave importance to the bristles of the manual toothbrush. Earlier studies have shown that 40% of the population preferred to buy manual toothbrush costing around Rs. 10–15,[14] whereas in the present study, 80% of educated, 57% of professionally employed, and 81% with higher family income had preferred purchasing them at price above Rs. 40.

Our study suggested that sociodemographic variables such as education, occupation, and family income had superior importance in influencing the selection of manual toothbrush among general population. However, to increase our understanding of sociodemographic variables affecting the preference of manual toothbrush, further studies could be directed to rank the variables affecting choices and also using a conjoint analysis method.

The limitation of the present study is that we would have made the participants to rank the multiple choices in each manual toothbrush attributes for better results giving utility scores. The strength was that we have considered all aspects of a manual toothbrush influencing the selection. Further research for substantiation of people's choices for selection of manual toothbrush can be better explained through qualitative studies among different groups of population.

  Conclusion Top

The results of the study highlight the role of education, occupation, and income of the consumers in selecting the choices of their manual toothbrush. The results of this study can be used to customize the choices of toothbrush aids based on the socioeconomic profiles of the end users. Further, the study results can also be used as an indirect indicator of the oral health knowledge of this population.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health Nutr 2004;7:201-26.  Back to cited text no. 1
Turner J. Are there Really More Mobile Phone Owners than Toothbrush Owners? The 60 Second Marketer. Atlanta: Sixty Marketing Optimization; 10 April, 2016; 05 September, 2016. Available from: https://www.linkedin.com. [Last accessed on 2016 Sep 05].  Back to cited text no. 2
Goel N. India Oral Care Industry Outlook to 2018. India: Ken Research Publications KR120; January, 2014; 05 September, 2016. Available from: https://www.kenresearch.com. [Last accessed on 2016 Sep 05].  Back to cited text no. 3
Vani G, Ganesh Babu M, Panchanatham N. Tooth paste brands – A study of consumer behaviour in Bangalore city. J Econ Behav Stud 2010;1:29.  Back to cited text no. 4
Frandsen A. Mechanical oral hygiene practices. In: Loe H, Kleinman DV, editors. Dental Plaque Control Measures Andoral Hygiene Practices. Oxford, Washington DC: IRL Press; 1986. p. 93-116.  Back to cited text no. 5
Kote S, Dadu M, Sowmiya AR, Aruna DS, Arora D. Knowledge, attitude and behaviour for choosing oral hygiene aids among students of management institutes, Ghaziabad, India. West Indian Med J 2013;62:758-63.  Back to cited text no. 6
Sripriya N, Shaik Hyder Ali KH. A comparative study of the efficacy of four different bristle designs of tooth brushes in plaque removal. J Indian Soc Pedod Prev Dent 2007;25:76-81.  Back to cited text no. 7
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Bairwa M, Rajput M, Sachdeva S. Modified Kuppuswamy's socioeconomic scale: Social researcher should include updated income criteria, 2012. Indian J Community Med 2013;38:185-6.  Back to cited text no. 8
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Nield-Gehrig JS, Willmann DE. Foundations of Periodontics for the Dental Hygienist. 1st ed. Mishawaka, USA: Lippincott Williams & Wilkins; 2003.  Back to cited text no. 9
Claydon NC. Current concepts in toothbrushing and interdental cleaning. Periodontol 2000 2008;48:10-22.  Back to cited text no. 10
Sowinski J, Petrone DM, Wachs GN, Chaknis P, Kemp J, Sprosta AA, et al. Efficacy of three toothbrushes on established gingivitis and plaque. Am J Dent 2008;21:339-45.  Back to cited text no. 11
Mackey R. Manual or Electric? Suggestions on Tooth Brush Selection. Sydney: Natural Dentistry; 28 August, 2012; 05 September, 2016. Available from: http://www.natural-dentistry.com. [Last accessed on 2016 Sep 05].  Back to cited text no. 12
Karve S. National monthly refereed journal of research in commerce and management. Abhinav Publ 2011;1:103-15.  Back to cited text no. 13
Ganjre K, Shinde G. Brand building strategies for tooth brush – A case study with Colgate. The Hindu Business Line; 14 August, 2014; 05 September, 2016. Available from: http://www.thehindubusinessline.com. [Last accessed on 2016 Sep 05].  Back to cited text no. 14


  [Table 1], [Table 2]

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