Abstract
BackgroundTo investigate the association between critical and communicative oral health literacy (OHL) and oral health outcomes (status, oral health-related quality of life and practices) in adults.MethodsThis cross-sectional study examined a household probability sample of 248 adults, representing 149,635 residents (20–64 years old) in Piracicaba-SP, Brazil. Clinical oral health and socioeconomic and demographic data, as well as data on oral health-related quality of life (OHIP-14) and health practices were collected. The oral examinations were carried out in the participants’ homes, using the World Health Organization criteria for oral diseases. The critical and communicative OHL instrument was the primary independent variable, and it was measured using five Likert items that were dichotomized as ‘high’ (‘agree’ and ‘strongly agree’ responses for the 5 items) and ‘low’ OHL. Binary and multinomial logistic regressions were performed on each outcome (oral health status and practices), controlling for age, sex and socioeconomic status (SES).ResultsApproximately 71.5% presented low OHL. When adjusted for age and sex (first model) low OHL was associated with untreated caries (Odds Ratio = 1.92, 95% Confidence Interval = 1.07–3.45), tooth brushing <3 times a day (OR = 2.00, 1.11–3.62) and irregular tooth flossing (OR = 2.17, 1.24–3.80). After SES inclusion in the first model, significant associations were found for low OHL when the outcomes were: presence of biofilm (OR = 1.83, 1.08–3.33), dental care for emergency only (OR = 2.24, 1.24–4.04) and prevalence of oral health impact on quality of life (OR = 2.06, 1.15–3.69).ConclusionAdjusting for age, sex and SES, OHL is related to a risk factor (biofilm) and a consequence of poor oral health (emergency dental visits) and can interfere with the impact of oral diseases on quality of life. As low OHL can be modified, the results support oral health promotion strategies directed at improving critical and communicative oral health literacy in adult populations.
Highlights
IntroductionTo investigate the association between critical and communicative oral health literacy (OHL) and oral health outcomes (status, oral health-related quality of life and practices) in adults
To investigate the association between critical and communicative oral health literacy (OHL) and oral health outcomes in adults
It was found in bivariate analysis that use of dental services for emergencies and/or dental pain was associated with low OHL, as well as tooth brushing less than twice daily, a greater prevalence of severe impact on oral health-related quality of life (OHRQoL), and presence of untreated caries (Table 1)
Summary
To investigate the association between critical and communicative oral health literacy (OHL) and oral health outcomes (status, oral health-related quality of life and practices) in adults. It is recognised that socioeconomic conditions are determinants of oral health, and in turn, oral health is an integral part of general health and quality of life [1]. The concept of health literacy is wider than being able to read pamphlets and look for health services; it involves a set of skills needed to improve one’s capacity to use health information effectively, which means that health literacy is critical to empowerment [4]. The concept of health literacy involves the ability to act politically to influence decision-making that will exert control over the social and economic determinants of health, which is a common omission among illiterate people [6]
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