Although toothbrushing is almost universally practised in Australia, there has been a decline in toothbrushing frequency. The proportion of children brushing their teeth less than once a day, among children when they start brushing with toothpaste, has almost doubled between 1993 and 2000. Although reducing the risk of very mild or mild dental fluorosis, this would have also reduced exposure to the protective effects of fluoridated toothpaste.

The proportion of children brushing with low-fluoride children’s toothpaste, as is recommended for children aged 6 years or under, has increased. Most young children now use low-fluoride toothpaste.

The inappropriate eating or licking of toothpaste has increased, both when children start brushing and at 5 years of age. This is an established risk factor for dental fluorosis with no benefit in preventing dental caries.