|Year : 2022 | Volume
| Issue : 2 | Page : 174-177
The characteristics of a good toothpaste from the viewpoint of laypeople: A qualitative study in Mashhad, Iran
Hooman Keshavarz1, Navid Jamalzadeh2, Iman Parisay3
1 Department of Community Oral Health; Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
|Date of Submission||09-Jul-2021|
|Date of Decision||20-Aug-2021|
|Date of Acceptance||16-Mar-2022|
|Date of Web Publication||8-Jun-2022|
Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Opposite Mellat Park, Vakilabad Blvd, Mashhad
Source of Support: None, Conflict of Interest: None
Introduction: Mechanical methods are known as the most effective methods of controlling and reducing the volume of dental plaque, and brushing teeth with toothpaste is the most common mechanical method. The objective of this study was to describe the characteristics of a good toothpaste from the viewpoint of the residents of Mashhad, Iran. Methods: In a qualitative study, a purposive sample of the residents of Mashhad (the second most populous city of Iran with almost three million residents) was interviewed. By attending different hypermarkets in the city, people were chosen among those who were going to buy toothpaste and invited to participate in this study. Participants were asked, “What do you think a good toothpaste should be?” All of the interviews were recorded and transcribed verbatim. After the first interview, the transcript was prepared, the thematic content analysis process began, and the interviews and the process continued until no new themes emerged and the data saturation was achieved. Results: In total, 13 people were interviewed during this study. The thematic content analysis process on the transcripts of the interviews finally resulted in seven categories including cosmetic properties, familiarity, therapeutic and preventive properties, economical, ease of use, attractive appearance, and multipurpose. Conclusions: It seems that in addition to the fluoride content of toothpaste, Iranians consider many other factors in choosing their toothpaste. Paying attention to what is important to them in the production of toothpaste can lead to their greater desire to use toothpaste and ultimately promote their oral health.
Keywords: Interview, qualitative research, toothpastes
|How to cite this article:|
Keshavarz H, Jamalzadeh N, Parisay I. The characteristics of a good toothpaste from the viewpoint of laypeople: A qualitative study in Mashhad, Iran. J Indian Assoc Public Health Dent 2022;20:174-7
| Introduction|| |
Unfortunately, oral diseases, especially dental caries and periodontal diseases, are still a public health problem worldwide. In almost all countries, dental caries and periodontal diseases are among the most common preventable infectious diseases.,, These diseases are one of the main causes of oral pain, tooth loss, and reduced quality of life, and their treatment costs make up a significant portion of the costs of health systems.
Since dental plaque plays an important role in the development of dental caries and periodontal diseases, controlling dental plaque can be very effective in preventing these diseases.,, Various methods have been proposed to control dental plaque, which can be divided into two general categories: mechanical methods and nonmechanical methods. Mechanical methods are known as the most effective methods of controlling and reducing the volume of dental plaque, and brushing teeth with toothpaste is the most common mechanical method.,,
The common use of toothbrushes and toothpaste in different populations has made them the subject of many studies.,,, However, unfortunately, no studies, to our knowledge, have qualitatively examined customers' opinions and views about these two goods. However, in line with the well-known approach of customer orientation in business management, if we want to encourage more people to brush their teeth with toothpaste and have people's satisfaction of brushing their teeth in the long-term, we should know people's openly expressed opinions and preferences about toothbrushes and toothpaste.
The objective of this study was to describe the characteristics of a good toothpaste from the viewpoint of the residents of Mashhad, Iran.
| Methods|| |
This phenomenological qualitative study was conducted in 2018 (from February to June) by interviewing a purposive sample (13 persons) of the residents of Mashhad (the second most populous city of Iran with almost three million residents). By attending seven different hypermarkets in the city [Figure 1], people were chosen among those who were going to buy toothpaste and invited to participate in this study. None of the invited people refused to participate in the study. For the convenience of the participants, the interviews were held at a quiet place away from other customers in the hypermarkets. Participants were asked, “What do you think a good toothpaste should be?” All of the interviews were recorded (the average duration of the interviews was 7.8 min) and transcribed verbatim. The accuracy of the transcripts was confirmed by the participants through phone calls. After the first interview, the transcript was prepared, the thematic content analysis process, began, and the interviews and the process continued until no new themes emerged and the data saturation was achieved. The verification of data analysis and resulted themes was done through peer review by another experienced researcher.
|Figure 1: The location of seven hypermarkets where sampling and interviews were conducted on the map of Mashhad, Iran|
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This study was approved by the Ethics Committee of School of Dentistry, Mashhad University of Medical Sciences (Approval code: IR.MUMS.SD REC.1394.240). Written informed consent was obtained from all the participants. The consent of the participants for participating in the study, and in particular recording the interviews, was also received verbally at the beginning of the interviews. All methods were carried out in accordance with relevant guidelines and regulations (Declaration of Helsinki).
| Results and Discussion|| |
In total, 13 people (8 men and 5 women) who were going to buy toothpaste in the selected hypermarkets were interviewed during this study. The mean age (standard deviation) of the participants was 40.1 (9.8) years; the youngest and the oldest participant were 26 and 57 years old, respectively. The thematic content analysis process on the transcripts of the interviews resulted in 54 initial codes. Considering the similarities, the initial codes were finally divided into seven categories, some of which (four categories) have subcategories themselves. The final seven categories were cosmetic properties, familiarity, therapeutic and preventive properties, economical, ease of use, attractive appearance, and multipurpose. [Figure 2] presents all the categories and subcategories with colored circles (each category and its subcategories are marked with a different color) whose diameters are proportional to the number of times the codes related to them were repeated in the interviews.
|Figure 2: The final categories and subcategories of the characteristics of good toothpaste from the viewpoint of the residents of Mashhad, Iran (the diameter of the circles is proportional to the number of times each item is repeated in the interviews)|
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The characteristics most frequently mentioned in the interviews were related to this category. Studies which have investigated people's motivations for brushing their teeth have also shown that cosmetic reasons have been one of the main motivations for most people's brushing.,,[1 9] Based on similarities and to homogenize the categories as much as possible, this category was divided into two subcategories: anti-calculus and whitening and good flavor and aroma.
Anti-calculus and whitening
However, in this study, the prioritization of characteristics in terms of importance had not been considered a goal, and if that were the case, the less repetition of a characteristic in the interviews alone would not be a good reason to underestimate that characteristic, the fact that being anti-calculus and being whitening were mentioned in the interviews more than any other characteristics is worth noting.
“I've been buying … (brand of a toothpaste) for some time … because this one whitens more” (Participant no. 3)
“The whitening feature is more important for me, being scaler,… and …. These are the features I consider for choosing a toothpaste.” (Participant no. 5)
In most of the interviews, sentences similar to the ones mentioned above could be easily found. In some cases, people were even looking for a specific type of the whitening characteristic that has to be clearly written on the packaging.
“I want it to be whitening. Glowing white, I want this phrase to be written on the packaging.” (Participant no. 2)
Good flavor and aroma
As presented in [Figure 2], people's attention to the flavor and aroma of toothpaste was seen in many interviews. In some other studies, the attention of most people to the taste of toothpaste has also been explicitly mentioned as an effective factor in choosing a toothpaste. In this regard, some quotes are as follows:
“It is good that it is very icy. I think it should cool the mouth a lot.” (Participant no. 3)
“It is important that its fragrance can eliminate bad breath or not.” (Participant no. 6)
The familiarity of a toothpaste also seems to be of interest to many people. Of course, according to the method of acquaintance, two subcategories were recognizable: through marketing and through experience.
Some pointed to the importance of friends' experiences: “Among friends, we ask a person whose teeth are healthier and whiter what toothpaste you are using.” (Participant no. 1)
Some others emphasized family members' experiences: “My children choose a toothpaste. They choose the toothpaste they are most satisfied with. My wife and I use the same.” (Participant no. 4)
The importance of manufacturers' advertising and marketing was also evident in the speeches of some people: “I choose from the most famous ones. ... and ..., they are advertising a lot now.” (Participant no. 3)
In some other studies, advertising and friends' experiences have been also mentioned as the most important factors influencing the choice of toothpaste.
Therapeutic and preventive properties
It can be said that most of the commonalities between professional and nonprofessional perspectives on the characteristics of a good toothpaste can be found in this category. Although the characteristics associated with this category have not been considered in all the interviews, this category has been ranked third in terms of the number of repetitions of the associated characteristics. This category can be divided into two subcategories: preventive (anticaries) and therapeutic (anti-sensitivity). Of course, prevention and treatment are two sides of the same coin, and any treatment actually prevents the condition from getting worse.
As dentists' advice to their patients and public oral health education emphasize the use of fluoride-containing toothpaste, the importance of fluoride has been somehow mentioned in all the characteristics associated with the preventive subcategory.
“It should have fluoride; it is said to be useful for strengthening teeth.” (Participant no. 9)
The anti-sensitivity feature of toothpaste has received much less attention in interviews than its fluoride content, but it still seems to be very important for people with sensitive teeth.
“My wife and I have some sensitive teeth. That's why I choose toothpaste that is for sensitive teeth.” (Participant no. 13)
The fact that the presence of fluoride in toothpaste is effective in the choice of toothpaste by most people has been mentioned in some other studies. Dani also pointed out in his study that health benefits and prevention of tooth decay were the most important feature of toothpaste for more than half of the study participants.
Nowadays, it has become almost obvious that the price of a product affects its sales in competition with other similar products. Dani reported in his study that about one-fifth of the participants chose their toothpaste based on its price. In our study, some participants also explicitly mentioned the importance of being economical as one of the characteristics of a good toothpaste.
“Considering its price, its size is appropriate or not. Price is also very important these days.” (Participant no. 8)
Ease of use
Today, meeting daily needs is much easier than it was before the Industrial Revolution. Now that the basic needs are being met with less effort than in the past, why not go into more detail. Some participants in this study, along with other features, also noticed the ease of use of toothpaste. Some noted the importance of the tube material, while others noted the importance of the tube cap shape.
“It should be easy to use. The tube material of some toothpastes is such that more force must be used to apply the toothpaste on the toothbrush.” (Participant no. 7)
“The tube model is very important. The tube cap should be such that toothpaste can be easily placed on the toothbrush.” ([Participant no. 8)
Given the importance that people attach to the appearance of toothpaste tubes,, it seems that a decorative role should be also considered for toothpaste as one of the toiletries. In this study, the importance of toothpaste appearance was also considered by the participants.
“The appearance of toothpaste is also somewhat effective. It should look attractive.” (Participant no. 8)
They like to hit as many targets as possible with one bullet. The previous sentence may best reflect the views of some participants in this study who pointed to being multipurpose as one of the characteristics of a good toothpaste.
“It should be written that it is multipurpose. Must do at least three or four things at a time.” (Participant no. 1)
| Conclusions|| |
It seems that in addition to the fluoride content of toothpaste, Iranians consider many other factors in choosing their toothpaste. Paying attention to what is important to them in the production of toothpaste can lead to their greater desire to use toothpaste and ultimately promote their oral health.
This article was originated from a graduate thesis registered under #2981 at the Academic Affairs Office of School of Dentistry, Mashhad University of Medical Sciences.
Financial support and sponsorship
This study was financially supported by the Mashhad University of Medical Sciences under Grant (number 960026). The funder played no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Petersen PE. World Health Organization global policy for improvement of oral health – World Health Assembly 2007. Int Dent J 2008;58:115-21.
Featherstone JD. The science and practice of caries prevention. J Am Dent Assoc 2000;131:887-99.
Petersen PE. The World Oral Health Report 2003: Continuous improvement of oral health in the 21st
century – The approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31 Suppl 1:3-23.
Axelsson P, Lindhe J. The effect of a plaque control program on gingivitis and dental caries in school children. J Dent Res 1977;56:142-8.
Greenstein G. Periodontal response to mechanical non-surgical therapy: A review. J Periodontol 1992;63:118-30.
Colombo AP, do Souto RM, da Silva-Boghossian CM, Miranda R, Lourenço TG. Microbiology of oral biofilm-dependent diseases: Have we made significant progress to understand and treat these diseases? Curr Oral Health Rep 2015;2:37-47.
Rosema NA, Hennequin-Hoenderdos NL, Berchier CE, Slot DE, Lyle DM, van der Weijden GA. The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol 2011;13:2-10.
Terézhalmy GT, Bartizek RD, Biesbrock AR. Relative plaque removal of three toothbrushes in a nine-period crossover study. J Periodontol 2005;76:2230-5.
Brothwell DJ, Jutai DK, Hawkins RJ. An update of mechanical oral hygiene practices: Evidence-based recommendations for disease prevention. J Can Dent Assoc 1998;64:295-306.
Elkerbout TA, Slot DE, Rosema NM, Van der Weijden GA. How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises. Int J Dent Hyg 2020;18:17-26.
Wright JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR. Fluoride toothpaste efficacy and safety in children younger than 6 years: A systematic review. J Am Dent Assoc 2014;145:182-9.
Van der Weijden GA, Hioe KP. A systematic review of the effectiveness of self-performed mechanical plaque removal in adults with gingivitis using a manual toothbrush. J Clin Periodontol 2005;32:214-28.
Twetman S, Axelsson S, Dahlgren H, Holm AK, Källestål C, Lagerlöf F, et al.
Caries-preventive effect of fluoride toothpaste: A systematic review. Acta Odontol Scand 2003;61:347-55.
Brannback M. The Concept of Customer-Orientation and its Implication for Competence Development. Innomarket, Turku School of Economics and Business Administration, Technical Reports; 1999. p. 1.
Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ 2000;320:114-6.
Burnard P, Gill P, Stewart K, Treasure E, Chadwick B. Analysing and presenting qualitative data. Br Dent J 2008;204:429-32.
Walker KK, Steinfort EL, Keyler MJ. Cues to action as motivators for children's brushing. Health Commun 2015;30:911-21.
Ayo-Yusuf OA, Booyens S. Principal motives for tooth-brushing in a population of South African adolescents: Implications for oral health promotion. SADJ 2011;66:174-8.
Macgregor ID, Balding JW, Regis D. Motivation for dental hygiene in adolescents. Int J Paediatr Dent 1997;7:235-41.
Adegbulugbe IC, Adegbulugbe IC. Factors governing the choice of dentifrices by patients attending the Dental Centre, Lagos University Teaching Hospital. Nig Q J Hosp Med 2007;17:18-21.
Dani V. Buying behavior of toothpaste in urban India: A study on Pune city. Pac Bus Rev Int 2013;5:48-56.
Vaikunthavasan S. Factors Affecting the Consumers' Choices of Toothpaste in Jaffna, Sri Lanka. Proceedings of Jaffna University International Research Conference (JUICE-2012), Sri Lanka; 2014. p. 70-8.
[Figure 1], [Figure 2]