Oral Health Literacy Level Research Articles

Oral Health Literacy and Behavior of Health Sciences University Students

Objective: This study aimed to determine the level of oral health literacy and behavior among health sciences. Methods: The method used descriptive cross-sectional survey involving 609 students from Faculty of Medicine, Dentistry, Pharmacy and Allied Health Sciences in the Universiti Kebangsaan Malaysia. Oral health literacy level and behaviour was assessed with a validated and pretested self-administered questionnaire using the Newest Vital Sign (NVS) tool and modified Oral Health Adult Literacy Questionnaire (OHL-AQ). Results: A total of 509 participants involved in the study (83.6%). The overall mean oral health literacy score was 10.27 (95% CI 7.92, 12.62), which found dental students showing statistically significant higher scores (mean=11.36, 95% CI 9.70, 13.02) compared to medical (mean=10.72, 95% CI 8.67, 12.77), allied health sciences (mean=9.89, 95% CI 7.34, 12.44) and pharmacy (mean=9.55, 95% CI 7.23, 11.87). Almost all respondents are non-smokers (99.8%) and non-drinkers (97.2%). Only 19.1% pay regular dental visits every 6-12 months while 51.1% visit dentist only when they have dental pain. Conclusion: There appears to be a positive relationship between oral health literacy and oral health behavior. Health science university students should be provided substantial dental health education in their curriculum as they show good potential as strategic partners in oral health. DOI: 10.14693/jdi.v22i2.404

Oral Health Literacy Among Carers of Special Needs Children in Kuala Terengganu, Malaysia

Oral health literacy (OHL) is important in empowering people to improve their general and oral health. Carers’ OHL may be associated with their ability to deliver good oral healthcare to their children. The aim of this pilot study was to assess the OHL among carers of special needs children. This is a descriptive cross-sectional study of carers in four Community-Based Rehabilitation Centre. Data were collected through a structured face-to-face interview of 40 carers. Oral Health Literacy Malay Version (OHLI-M) was measured using text passages and prompts with a total of 57 items. These items were used to assess comprehension and numerical ability of carers based on domains namely, accessing dental care, understand appointment and following medication instructions. The results showed that majority of the participants had ‘marginal’ and ‘adequate’ OHL level of 32.5% and 52.5%, respectively. Only four (10%) participants had ‘inadequate’ OHL level. The ‘reading comprehension’ and ‘numeracy’ sections’ mean scores were 37.54 (95% CI 35.7-39.4) and 38.17 (95% CI 34.8-41.6). The total OHL mean score was 75.7 (95% CI 71.2-80.2). In conclusion, majority of the carers of special needs children in this sample had moderate OHL. Such information is important to develop more appropriate intervention programmes for carers to match their OHL.

Conceptual measure of oral health literacy level among patients visiting a private dental institution in Dharwad: A cross-sectional questionnaire study

Introduction: Oral health literacy (OHL) is the ability of an individual to function independently in certain areas of oral health care activity. It has now evolved as an important determinant of oral health related behavior and practices in any population thus affecting a person's health outcome. Aim: To assess the OHL levels among the sample of a population visiting private dental college and hospital in Dharwad. Materials and Methods: A cross-sectional questionnaire study was conducted on patients visiting a private dental college and hospital in Dharwad. Data was collected from 225 subjects through questionnaire related to five different areas of health care activity. Responses were scored on a dichotomous scale. Analysis of variance and independent t-test were used. Results: Among the study population, 67.6% had medium OHL levels, 24.9% had low, and only 7.6% had high OHL level. OHL had a significant association with age and educational qualification (P < 0.05), whereas gender had no significant association (P < 0.05). Conclusion: Majority had an OHL of medium level as age advanced OHL was lower. As the educational qualification was higher, OHL also improved. This makes education an important parameter in improving the OHL. There is a need to consider OHL while planning future oral heath related programs for this population.

Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren.

ABSTRACTAim: The aim of this study was to determine the oral hygiene facilitators and barriers for 10 years old Greek children, via a questionnaire and clinical examination.Materials and methods: This was a cross-sectional study of 266, 10 years old, children recruited from schools in 3 locations in Greece. Data were collected via questionnaires and clinical examination. Questionnaires referred to Children’s oral hygiene knowledge, behavior and attitude as well as parents’ oral hygiene behavior and educational level. Children were clinically examined by two calibrated pediatric dentists using a WHO probe and artificial light to assess dental plaque (hygiene index-HI), gingivitis (simplified gingival index-GIs) and dental caries (DMFT-BASCD criteria).Results: Regarding oral hygiene knowledge, although 80% of the children were literate of the proper means of oral hygiene, only 58.64% brushed their teeth twice daily and 36.84% used dental floss. Children’s oral hygiene knowledge was positively correlated with both parental brushing frequency (ρ = 0.175, p < 0.05) and educational level (ρ = -0.216, p < 0.05). Toothpaste use was reported by 92.11% of the children. Regarding Children’s attitude, 62.28% were concerned whether their teeth were clean, with girls showing greater concern than boys (p < 0.001). Their reported beliefs regarding brushing avoidance were boredom (84.06%), low oral health literacy (73.91%) and forgetfulness (56.52%).Conclusion: Oral hygiene facilitators were found to be the concern about how clean were their teeth, oral health literacy of both children and parents and toothpaste appeal to children. Oral hygiene barriers were Children’s boredom, low oral health literacy, forgetfulness and low socioeconomic level.How to cite this article: Angelopoulou M, Kavvadia K, Oulis C, Reppa C. Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren. Int J Clin Pediatr Dent 2015;8(2):87-93.

The Relation Between Caregivers' Multiliterate Reading Habits and Their Children's Oral Health Status.

BackgroundCaregivers’ oral health literacy (OHL) assessment results have been found to be related to their children’s oral health status. A further aspect of this relationship may be the role of caregivers’ reading habits.ObjectiveOur goal was to describe the relationship between caregivers’ multimodal (digital and print) and multilingual (English and Chinese) reading habits, their OHL, and their child’s oral health status in Hong Kong.MethodsA random sample of 301 child-caregiver dyads was recruited from kindergartens in Hong Kong. Data included sociodemographic information and caregivers’ self-reported digital print and reading habits across two languages (Chinese and English). Caregivers’ OHL levels were assessed by two locally developed and validated oral health literacy assessment tasks: Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) and the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (HKOHLAT-P). Children’s oral health status was assessed using two measures: dental caries experience (number of decayed, missing, and filled teeth) and oral hygiene status (Visible Plaque Index).ResultsBivariate variations revealed significant differences in mean OHL scores between caregivers with different reading habits (P<.01). Correlations revealed significant associations between caregivers’ practices of reading multimodal (print/digital) and multilingual (English/Chinese) texts, their literacy levels, and their children’s oral health status (P<.01). Adjusting for sociodemographics and all other reading habits in the regression analysis, the caregivers' habit of reading digital and print texts was significantly retained in the final model. Regression analysis revealed significant associations between caregivers’ reading habits (digital Chinese) and their OHL word recognition scores: OR 5.00, 95% CI 1.10-3.65, P=.027. Significant associations were also evident for their OHL comprehension scores (digital Chinese: OR 2.30, 95% CI 1.30-4.20, P=.004; print Chinese: OR 2.50, 95% CI 1.40-4.30, P=.001). However, no significant associations were found between caregivers' reading habits and child’s oral health status (P>.05).ConclusionsCaregivers’ habits of reading print and digital Chinese texts are significantly associated with their OHL scores. Their reading habits, however, do not affect their children’s oral health status.

An introduction to health literacy and oral health: the importance of awareness amongst dental care professionals

This article introduces the concept of oral health literacy and its potential impact on patient care to the dental team. Factors which influence an individual's level of functional oral health literacy are discussed, along with methods which have been developed to measure it. Finally, public health initiatives to improve oral health literacy are considered, along with measures that individual practitioners can take. Clinical Relevance: Oral health literacy may potentially play a vital role in the ability of patients to access and understand oral health information and treatment.

Enculturation, Myths and Misconceptions Regarding Oral Health Care Practices among Rural Female Folk of Rajasthan

Utilization of dental services is hampered by multiple barriers which include culturally influenced factors, misconceptions regarding oral health care, low education and health literacy level. The purpose of the study was to uncover the cultural and ritual practices and their effect on the oral cavity and the utilization of dental services. A cross-sectional door to door survey was conducted in Bhanpur Kalan village, Jaipur in which 600 females were surveyed using a pilot tested, structured 14-item, close-ended, self- administered questionnaire. Chi-square test was employed for inter group comparison of variables. It was revealed that myths and misconceptions associated with dental treatment and ritual practices were significantly higher among uneducated females as compared to educated females (p<0.005). Cultural beliefs act as access barriers for the utilization of dental services. Co- ordinated efforts by dentists and other health professionals are required to impart dental health education and improve knowledge about oral health and oral hygiene practices.

Enculturation, Myths and Misconceptions Regarding Oral Health Care Practices among Rural Female Folk of Rajasthan

Utilization of dental services is hampered by multiple barriers which include culturally influenced factors, misconceptions regarding oral health care, low education and health literacy level. The purpose of the study was to uncover the cultural and ritual practices and their effect on the oral cavity and the utilization of dental services. A cross-sectional door to door survey was conducted in Bhanpur Kalan village, Jaipur in which 600 females were surveyed using a pilot tested, structured 14-item, close-ended, self- administered questionnaire. Chi-square test was employed for inter group comparison of variables. It was revealed that myths and misconceptions associated with dental treatment and ritual practices were significantly higher among uneducated females as compared to educated females (p<0.005). Cultural beliefs act as access barriers for the utilization of dental services. Co- ordinated efforts by dentists and other health professionals are required to impart dental health education and improve knowledge about oral health and oral hygiene practices.

Social Determinants and Oral Health: An Update

This review presents the most recent studies and evidence on the social determinants of oral health. Oral disease is associated with an array of structural determinants (income, goods, and services). It is also associated with daily living conditions, and social gradients have been reported for dental caries, periodontal disease, oral cancer, and tooth loss. Current understanding of these interconnections have prompted the development of a new approach for oral health promotion, which recognizes that the behaviors accounting for the most important noncommunicable diseases contribute to oral diseases as well. Oral diseases and issues such as poor access to dental care and low oral health literacy levels are social, political, behavioral, and medical in nature. These conditions will only be controlled by the promotion of initiatives that prioritize the improvement in the social determinants of health as a backbone structure for the development of healthy enabling environments.

Index of oral health literacy as the instrument for development of personalized prevention programs of stomatologic diseases

According to World Health Organization (WHO), dental caries is common among 60-90% of school children and nearly among 100% of adults. Further, severe form of periodontal disease is found in 15-20% of 35-44 years old patients. WHO experts emphasize that timely prevention of dental diseases will not only contribute importantly to mainitaining oral health but would also significantly reduce cost of care and treatment of oral diseases. An important component in the prevention of oral diseases is informing of patients about the possibility of maintaining oral health with the help of available oral hygiene products. For adequate and efficient planning of activities to raise oral health awareness it is necessary to estimate level of oral health literacy of the community. In different countries there are certain questionnaires which are primarily used during scientific research. Many of these questionnaires and tests are not well-suited for use in patients with different culture and language. We suggest that standardization of oral health literacy assessment would be conducive to more effective evaluation of oral health care needs of a given population. Thus, we have developed an index of oral health literacy which has the following characteristics: - questions are universal and reflect current trends of prevention of oral diseases; - questions have no cultural contexts and attachments; - questions can be translated into any language; - questions have some variants for answers; - quantitative assessment of oral health literacy. Pilot studies showed that the developed index of oral health literacy can reliably predict the level of knowledge in young patients and the state of the oral health. In conclusion, the use of the developed index should will allow assessment of oral health literacy of patients regarding aspects of oral health preservation irrespective of nationality and language should facilitate the development of personalized approaches to prevention of dental diseases.

Impact of oral health literacy on oral health-related quality of life among adults

Objectives: The purpose of this study was to assess the impact of oral health literacy on oral healthrelated quality of life (OHRQoL). Methods: Self-administered questionnaires were handed out to 760 adults above the age of 18 selected through convenience sampling. Among them, those above 60 years of age were also interviewed face-to-face. The Rapid Estimate of Adult Literacy in Dentistry (REALD-99) and the Test of Functional Health Literacy in Dentistry (TOFHLiD) were used to measure verbal and functional oral health literacy respectively. OHRQoL was measured using the oral health impact profile-14 (OHIP-14), a simplified version of the oral health impact profile (OHIP). The sociodemographic characteristics (gender, age, marital status, education level, and income) were also recorded. Higher scores on oral health literacy represented higher levels of literacy, while higher OHIP-14 scores implied that the OHRQoL was lower. Results: During analyses, the sample was stratified into the top and bottom 25% based on functional oral health literacy levels. OHRQoL had a statistically significant negative correlation with functional oral health literacy. The items on functional limitation, physical disability, social disability, and handicap specifically showed negative correlations. Multiple regression analysis was performed after including sociodemograhic variables also. Only functional and not verbal oral health literacy had a statistically significant influence on OHRQoL. The higher the functional oral health literacy level, the higher was the OHRQoL. Conclusions: Enhancement of functional oral health literacy level through oral health education is necessary to improve the OHRQoL.

Association between oral health literacy and oral health-related quality of life among undergraduate students in Bengaluru city

Introduction: Oral health literacy (OHL) is the new imperative for better oral health as health literacy is now considered a determinant of health. The complexity of both verbal and written oral health communications creates a significant barrier to improving oral health. Aim of the Study: To determine the association between OHL and oral health-related quality of life (OHRQoL) among undergraduate students in Bengaluru City. Materials and Methods: For a cross-sectional survey among 400 undergraduate students (PUC, BA, B.Com, BBM, B.Sc, BE), 10 colleges were randomly selected in Bengaluru city. The structured proforma including oral health impact profile-14 (OHIP-14) was administered to the study participants. Rapid estimate of adult literacy in dentistry-30 (REALD-30) was provided to each participant to be read aloud in front of the interviewer. The data were analyzed using descriptive statistics, ANOVA and correlation coefficient test. A P < 0.05 was considered to be significant. Results: Mean OHIP-14 score ranged from 16.2 ± 3.52 (BBM) to 21.5 ± 7.5 (BA) with significant differences among streams (P = 0.036). Mean REALD-30 ranged from 12.76 ± 4.61 to 18.85 ± 3.42 with significant differences between groups (P < 0.001). OHIP-14 and REALD-30 showed positive correlation for PUC (r = 0.072), B.Com (r = 0.314), B.Sc (r = 0.448) and BE (r = 0.245); negative correlation for BBM (r = −0.09). However significant correlation was observed among B.Sc and BE students (P < 0.05). Conclusion: Oral health literacy was significantly associated with OHRQoL. Hence raising OHL levels may have an impact on OHRQoL.

Application of visual oral health literacy instrument in health education for senior high school students

There is a discrepancy in knowledge and comprehension about oral health between dental professionals and students. Therefore, for dental professionals to give health education, it is essential that they fully understand students' oral health literacy level. The purpose of this research was to determine the usefulness of a mouth drawing as a visual oral health literacy instrument by comparing changes in health literacy before and after oral health education. Mouth drawing by students, as the visual oral health literacy instrument, was conducted before (first drawing) and after (second drawing) oral health education in 2010 to 162 Japanese senior high school students. Tooth and gingiva scores were calculated based on the criteria and changes in the scores before and after oral health education were analyzed. Tooth scores were significantly higher than gingiva scores in both male and female students. Comparison of scores before and after health education showed that both tooth and gingiva scores significantly increased after health education. A student's self-evaluation comparing his/her own first and second drawings showed that 72.8% of all students answered the ‘second drawing’ was better, and 27.2% answered the ‘first drawing’ or ‘the same’. A visual oral health literacy instrument makes possible evaluation of students' oral health literacy both visually and quantitatively. A proper health education program, based on the subjects' oral health literacy level, should effectively improve oral health behavior and oral health status.

Determinants of Oral Health: Does Oral Health Literacy Matter?

Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 participants (mean age 36.3 (SD 12.9); 51% female), women reported brushing their teeth more frequently (P < 0.001) and scored higher for oral health literacy (mean 10.9 versus 10.2, P < 0.001). In the adjusted model, high age (OR = 1.01, 95% CI 1.003–1.034), low education (OR = 1.88, 95% CI 1.23–2.87), small living area in square meters per person (OR = 1.85, 95% CI 1.003–3.423), poor tooth brushing behavior (OR = 3.35, 95% CI 2.02–5.57), and low oral health literacy scores (OR = 1.58, 95% CI 1.02–2.45) were significant risk indicators for poor self-reported oral health. Conclusions. Low oral health literacy level, independent of education and other socioeconomic determinants, was a predictor for poor self-reported oral health and should be considered a vital determinant of oral health in countries with developing health care systems.

The impact of oral health literacy on periodontal health status

The objective of this study was to describe oral health literacy (OHL) among periodontal patients and to examine its association with periodontal health status. This cross-sectional study included new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinic. Sociodemographic and dental history information were collected. OHL was measured using a dental word recognition instrument, Rapid Estimate of Adult Literacy-30 (REALD-30). Clinical periodontal examinations were completed. One hundred and twenty-eight participants enrolled and 121 completed all study examinations and instruments. Despite a high level of education among participants in our study, low levels of OHL were found in one-third (33 percent) of the study population. Thirty-one percent had moderate OHL (score of 22-25), 37 percent had high OHL (score ≥ 26). The mean REALD-30 score was 23. Fifty-three percent of participants had severe periodontitis, 29 percent had moderate periodontitis, and 18 percent had mild or no periodontitis. Bivariate analysis showed a significant association between OHL and periodontal status (P < 0.05). The effect of OHL on periodontal health status remained statistically significant (P < 0.002) even after controlling for smoking, race, and dental insurance. Lower OHL was associated with more severe periodontal disease among new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinics.

Examining the accuracy of caregivers' assessments of young children's oral health status

Caregivers' perceptions of their young children's oral health status (OHS) are a strong determinant of whether the children visit a dentist. Our aims were to quantify the correlation between caregivers' assessments and their children's clinically determined restorative treatment needs, while investigating factors related to this association. One hundred eight caregivers assessed their children's OHS by answering a question on the self-reported National Health and Nutrition Examination Survey III instrument. Children underwent clinical oral examinations at one of two study sites of the Carolina Oral Health Literacy Project: a dental school-based clinic and a community-based health clinic. Examiners recorded the children's clinical treatment needs by using a modification of the caries severity index. The authors quantified concordance between the two measures with use of the Spearman rank correlation (ρ) and Kendall τ rank correlation, whereas they assessed differences in sociodemographic factors and oral health literacy (OHL) levels by using a homogeneity χ(2) test (P < .2 criterion). The concordance between caregivers' assessments and clinically determined OHS was lower for younger children (< 2 years, ρ = 0.29 versus = 2 years, ρ = 0.63 [homogeneity P = .03]), a pattern that was evident in the community clinic but not in the university clinic. Caregivers' age, education and OHL did not influence the accuracy of self-reports. For children younger than 2 years, caregivers' assessments correlated poorly with clinical needs, which routinely were underestimated. Practice Implications. These findings underscore the importance of preventive dental visits at a young age and the early establishment of a dental home.

Relationship between oral health literacy and oral health behaviors and clinical status in Japanese adults

Background/purposeHealth literacy is recognized as an important determinant of health as well as a causal factor in health disparities among different population groups. However, the paucity of information on oral health literacy makes urgent the need for more research on this important topic. The objective of this study was to investigate how oral health literacy relates to oral health behaviors, as well as clinical dental and periodontal condition. Materials and methodsA self-administered questionnaire and dental examination collected information on demographics of 589 adult residents of Akita prefecture, Japan, including: oral health behaviors; oral hygiene status; oral health literacy; number of natural teeth, decayed teeth, and functional tooth units (FTUs); and community periodontal index. ResultsLess than half of the participants knew the Japanese words such as “dental plaque,” “scaling,” “gingivitis,” “fluoride mouth rinsing,” “8020 campaign,” “mouthwash,” and “denture plaque,” or answered “true” in response to the statement: “Scaling is related to periodontal disease.” The higher a participant’s oral health literacy, the more often they brushed their teeth or dentures, self-checked oral condition with a mirror, had regular dental checkups, and the better their oral hygiene status. Furthermore, individuals with higher oral health literacy had higher mean numbers of natural teeth, n-FTUs, and nif-FTUs. Participants with higher oral health literacy also had fewer decayed teeth. Participants with low oral health literacy were more likely to fall into a higher category of the community periodontal index code compared to those with high oral health literacy. ConclusionOur findings indicate that oral health literacy is associated with differences in oral health behaviors and clinical oral health status. An understanding of participants’ oral health literacy levels is crucial for designing effective health educational materials and creating intervention programs to promote oral health.

Oral health literacy and knowledge among patients who are pregnant for the first time

The authors conducted an observational cohort study to determine the levels of and examine the associations of oral health literacy (OHL) and oral health knowledge in low-income patients who were pregnant for the first time. An analytic sample of 119 low-income patients who were pregnant for the first time completed a structured 30-minute, in-person interview conducted by two trained interviewers in seven counties in North Carolina. The authors measured OHL by means of a dental word recognition test and assessed oral health knowledge by administering a six-item knowledge survey. The authors found that OHL scores were distributed normally (mean [standard deviation], 16.4 [5.0]). The percentage of correct responses for each oral health knowledge item ranged from 45 to 98 percent. The results of bivariate analyses showed that there was a positive correlation between OHL and oral health knowledge (P < .01). Higher OHL levels were associated with correct responses to two of the knowledge items (P < .01). OHL was low in the study sample. There was a significant association between OHL and oral health knowledge. Low OHL levels and, thereby, low levels of oral health knowledge, might affect health outcomes for both the mother and child. Tailoring messages to appropriate OHL levels might improve knowledge.

Oral health literacy levels among a low-income WIC population.

To determine oral health literacy (OHL) levels and explore potential racial differences in a low-income population. This was a cross-sectional study of caregiver/child dyads that completed a structured 30-minute in-person interview conducted by two trained interviewers in seven counties in North Carolina. Sociodemographic, OHL, and dental health-related data were collected. OHL was measured with a dental word recognition test [Rapid Estimate of Adult Literacy in Dentistry (REALD-30)]. Descriptive, bivariate, and multivariate methods were used to examine the distribution of OHL and explore racial differences. Of 1658 eligible subjects, 1405 (85 percent) participated and completed the interviews. The analytic sample (N=1280) had mean age 26.5 (standard deviation = 6.9) years with 60 percent having a high school degree or less. OHL varied between racial groups as follows: Whites--mean score = 17.4 (SE = 0.2); African-American (AA)--mean score = 15.3 [standard error (SE) = 0.2]; American Indian (AI)--mean score = 13.7 (SE = 0.3). Multiple linear regression revealed that after controlling for education, county of residence, age, and Hispanic ethnicity, Whites had 2.0 points (95 percent CI = 1.4, 2.6) higher adjusted REALD-30 score versus AA and AI. Differences in OHL levels between racial groups persisted after adjusting for education and sociodemographic characteristics.

Development and evaluation of an oral health literacy instrument for adults

To develop and validate an instrument to measure the functional oral health literacy of adults. For the generation of items different dental patient educational materials and text types were selected that had reading levels similar to materials used for the Test of Functional Health Literacy in Adults (TOFHLA) which was the model for our Oral Health Literacy Instrument (OHLI). The OHLI contains reading comprehension and numeracy sections. The reading comprehension section is a 38-item test with words omitted from one passage on dental caries and another on periodontal disease. The numeracy section has 19 items to test comprehension of directions for taking common prescriptions associated with dental treatment, postextraction instructions and dental appointments. We also developed a 17-item oral health knowledge test. The OHLI, the TOFHLA, the oral health knowledge test and a brief questionnaire were administered to a convenience sample of 100 patients. Internal reliability of OHLI was assessed with Cronbach's alpha. Test-retest reliability was examined by intra-class correlation coefficient (ICC). Concurrent validity was tested by comparing OHLI scores across categories of education level and frequency of dental visits. Construct validity was assessed by correlating OHLI scores with TOFHLA scores and with the oral health knowledge scores using Spearman's rho (rho) and multiple linear regression. Participants averaged 39 years (SD = 12.4); 73% were female; 64% had college/university education; 40% visited a dentist every 3-6 months. Total OHLI and TOFHLA weighted mean scores were 87.2 and 91.7, respectively (possible range 0-100). The Cronbach's alpha values were high (>0.7) for OHLI and its components. The ICC values indicated good agreement between the test and retest results for OHLI and the oral health knowledge test. Patients visiting a dentist every 3-6 months had significantly higher levels of oral health literacy than those visiting only when they felt pain. The association between OHLI and education level was not significant. OHLI scores were significantly correlated with the scores on the TOFHLA (rho = 0.613) and the test of oral health knowledge (rho = 0.573). These associations remained significant in multiple regression models. Initial testing of OHLI suggested that it is a valid and reliable instrument to evaluate oral health literacy among adults, although additional work is needed to investigate the instrument's predictive validity and sensitivity to change using oral health outcomes with population groups known to be at high risk of low functional oral health literacy.