Oral Health Literacy Scores Research Articles

Changes in Candida albicans, Streptococcus mutans and oral health conditions following Prenatal Total Oral Rehabilitation among underserved pregnant women

ObjectivesTo assess the oral health condition and oral microbial outcomes from receiving an innovative treatment regimen - Prenatal Total Oral Rehabilitation (PTOR). MethodsThis prospective cohort study included 15 pregnant women in the PTOR group who had a baseline visit before PTOR and three follow-up visits (immediate after, 2 weeks and 2 months) after receiving PTOR. A historical control group of additional 15 pregnant women was matched from a separate study based on a propensity score. Along with demographic and medical background, oral health conditions and perinatal oral health literacy were assessed. Oral samples (saliva and plaque) were analyzed to identify and quantify Streptococcus mutans and Candida species by culturing-dependent and -independent methods. ResultsSignificant reductions of salivary S. mutans were observed following PTOR, the effect remained until 2-month follow-up (p < 0.05). The carriage of salivary and plaque S. mutans at the 2-month visit of the PTOR group was significantly lower than that of the control group (p < 0.05). Oral health conditions reflected by BOP and PI were significantly improved upon receiving PTOR (p < 0.05). Receiving PTOR significantly improved the perinatal oral health literacy score, and the knowledge retained until 2-month follow-up (p < 0.05). ConclusionsPTOR is associated with an improvement in oral health conditions and perinatal oral health literacy, and a reduction in S. mutans carriage, within a 2-month follow-up period. Future clinical trials are warranted to comprehensively assess the impact of PTOR on the maternal oral flora other than S. mutans and Candida, birth outcomes, and their offspring's oral health.

Perceived Oral Health Literacy, Behaviors, and Oral Health Care among Caregivers to the Homebound Population

This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p &lt; .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score ( M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score ( M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.

Contextual and individual factors associated with oral health literacy in adolescents: A multi-level approach.

This study aimed to evaluate the association of contextual and individual factors with Oral Health literacy (OHL) in early adolescence. This is a population-based cross-sectional study carried out with 740 12-year-old adolescents randomly selected by a two-stage probabilistic cluster sampling process from schools in Campina Grande, Brazil. The guardians provided sociodemographic information. Adolescents answered the Brazilian version of the Family Adaptability and Cohesion Scales (FACES III) to measure family functioning, and the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30) to measure OHL. Descriptive analysis was conducted, followed by robust Poisson's regression analysis for complex samples with a multilevel approach (p<0.05). Rate ratio (RR) and 95% confidence intervals (CI) were calculated. The two levels of the analysis were students and schools. Adolescents enrolled at schools with higher grade-retention rate had slightly worse OHL scores (RR = 0.99; 95% CI: 0.98 to 0.99). The following individual factors were associated with the level of OHL: the female sex (RR = 1.05; 95% CI: 1.01 to 1.10), mother's schooling more than eight years (RR = 1.13; 95% CI: 1.08 to 1.19), younger guardians (RR = 0.94; 95% CI: 0.90 to 0.97) and a balanced family functioning (RR = 1.08; 95% CI: 1.01 to 1.14). Individual and contextual factors were associated with OHL in early adolescence.

Association of Oral Health Literacy and School Factors with Untreated Dental Caries among 12-Year-Olds: A Multilevel Approach

Dental caries are a global health problem that affects all age groups and must be considered a public health priority due to its significant financial costs and impact on the quality of life. This study evaluated the association between oral health literacy (OHL), school factors, and untreated dental caries in 12-year-old Brazilian adolescents using a multilevel approach. A population-based cross-sectional study was carried out with 740 adolescents randomly selected from private and public schools in Campina Grande, Brazil. Two dentists were trained and calibrated to diagnose dental caries using the Nyvad index and OHL using the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30). The caregivers of the adolescents reported demographic data (sex, skin color, and socioeconomic status). Data of school factors such as the type of school and the school grade retention rate were classified through a 2-step hierarchical cluster analysis to obtain the school environment. A robust multilevel log-linear negative binomial regression for complex samples was performed (p < 0.05). In the analysis, adjusted by individual determinants, nonwhite skin color (RR = 2.20; 95% CI 1.56–3.12), a low socioeconomic status (RR = 1.60; 95% CI 1.09–2.34), a low OHL score (RR = 0.94; 95% CI 0.91–0.98), and low satisfaction with the last dental appointment (RR = 2.25; 95% CI 1.67–3.04) were associated with untreated dental caries. The following factors remained associated with untreated dental caries in the final model: students from an unfavorable learning environment (RR = 2.20; 95% CI 1.27–3.80), nonwhite skin color (RR = 1.92; 95% CI 1.27–2.91), a low socioeconomic status (RR = 1.82; 95% CI 1.12–2.94), a low OHL score (RR = 0.95; 95% CI 0.91–0.98), and low satisfaction with the last dental appointment (RR = 2.07; 95% CI 1.47–2.91). Untreated dental caries in early adolescence were impacted by the school environment, the socioeconomic status, OHL, and the adolescent’s satisfaction with the last dental appointment.

Oral health literacy among third-level university students in cork city; Ireland

Health literacy is considered a social determinant of population health, but also relates to making informed health decisions. Little information is available on the oral health literacy (OHL) among young adults, and this is crucial to inform targeted interventions on oral health and care. This study (i) estimates the prevalence of OHL among the third-level university students in Cork City and (ii) identifies determinants of OHL by exploring potential correlates. All students in University College Cork (~ 21000) were sent out a previously validated questionnaire through the online Lime Survey in April 2018 (n = 1487). Both descriptive and inferential statistics (chi-squared/correlation) were undertaken. OHL score was calculated as adequate (2.1-3.0), marginal (1.1-2.0) or inadequate (0.0-1.0) in regard to the scores attained by the individuals. Adequate OHL prevalence was 23%. OHL was significantly correlated with age (r = 0.10), major discipline (r = - 0.13) and frequency of dental visits (r = - 0.08). Male gender, younger age group and those in non-medical schools had significantly higher inadequate OHL. Approximately, one-in-four third-level university students in Cork City have adequate OHL which is lower compared to the general Irish population but still significantly high in specific groups.

Changes in &lt;i&gt;Candida&lt;/i&gt;, Mutans Streptococci and Oral Health Conditions Following Prenatal Total Oral Rehabilitation Among Underserved Pregnant Women

Objectives: To assess the oral health condition and oral microbial outcomes from receiving an innovative treatment regimen - Prenatal Total Oral Rehabilitation (PTOR) Methods: This prospective cohort study included 15 pregnant women in the PTOR group who had a baseline visit before PTOR and three follow-up visits (immediate after, 2 weeks and 2 months) after receiving PTOR. A historical control group of additional 15 pregnant women was matched from a separate study based on a propensity score. Along with demographic and medical background, oral health conditions and perinatal oral health literacy were assessed. Oral samples (saliva and plaque) were analyzed to identify and quantify Streptococcus mutans and Candida species by culturing-dependent and -independent methods. Results: Significant reductions of salivary S. mutans were observed following PTOR, the effect remained until 2-month follow-up (p<0.05). The carriage of salivary and plaque S. mutans at the 2-month visit of the PTOR group was significantly lower than that of the control group (p<0.05). Oral health conditions reflected by BOP and PI were significantly improved upon receiving PTOR (p<0.05). Receiving PTOR significantly improved the perinatal oral health literacy score, and the knowledge retained until 2-month follow-up (p<0.05). Conclusions: PTOR is associated with an improvement in oral health conditions and perinatal oral health literacy, and a reduction in S. mutans carriage, within a 2-month follow-up period. Future clinical trials are warranted to comprehensively assess the impact of PTOR on the maternal oral flora other than S. mutans and Candida, birth outcomes, and their offspring's oral health. Funding Information: Dr. Xiao's work is supported by the grant from the National Institute for Health NIDCR K23DE027412. Dr. Wu’s work is supported by grant from the National Science Foundation NSF-CCF-1934962. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Declaration of Interests: The authors declare no conflict of interests. Ethics Approval Statement: The reported studies were approved by the University of Rochester Research Subject Review Board (#4628 and #1248). All participants were informed of the study objects and protocols, and gave written consent prior to study activities.

ORAL HEALTH LITERACY AMONG THE EMPLOYEES OF FACULTIES OF DENTISTRY AND ENGINEERING, ALEXANDRIA UNIVERSITY

Introduction: Oral health literacy which is considered as the skills required for people to obtain, process and understand basic health information needed to make appropriate oral health decisions is an important determinant of oral health. Employees of the Faculty of Dentistry spend their working hours surrounded by dental educational environment which may affect their dental awareness level. Objectives: To assess the oral health literacy level of the employees of the Faculty of Dentistry (FOD) and to compare the results with those of employees of Faculty of Engineering (FOE), Alexandria University. Materials and Methods: The sample comprised of 386 employees who were proportionally allocated into 78 FOD employees and 308 FOE employees approached in the different administrative departments of both faculties. Oral health literacy level was assessed using the Oral Health Literacy Adult Questionnaire (OHL-AQ). Results: The mean oral health literacy score for Faculty of Dentistry employees was significantly higher than that of the Faculty of Engineering employees (11.49±3.00, 10.34±3.20, respectively). According to the regression model, females (p=0.002), older age group (p=0.01) and higher educational level (p=0.001) were the main predictors of higher OHL-AQ scores. Conclusions: Oral health literacy level of the FOD employees was higher than that of the FOE employees which points to the positive effect of the dental educational environment on OHL of FOD participants.

Assessment of Parents' Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children.

(1) Purpose: To assess the oral health literacy (OHL) of parents and its association with the caries experience of their preschool children attending the Hospital University Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia. (2) Materials and Methods: This is a descriptive cross-sectional study involving a systematic random sampling method, using a sample of 230 parent/preschool child dyads. Among 230 parents, 24 were males and 206 were females (mean age 31.43 ± 5.82); among 230 children, 92 were boys and 138 were girls (mean age 4.82 ± 1.04) attending the pedodontics clinic, HUSM, who participated and met the inclusion criteria. A structured, self-administered oral health literacy questionnaire including sociodemographic factors was used in this study. A child’s oral examination was performed to check the dmft (decayed, missing, filled teeth) status. Statistical analysis was done using descriptive and Spearman’s correlation analysis and multivariate regression analysis. (3) Results: The mean dmft score of children in relation to the OHL level of parents showed a significant difference (p < 0.00). The mean dmft score of children in relation to the OHL level of parents showed the following relationships: Inadequate (7.49 ± 4.10) followed by marginal (3.28 ± 2.67) and then adequate (0.55 ± 1.55). The incidence of caries amongst children in relation to parental employment was more associated with unemployed parents (6.11 ± 4.43) than with employed parents (2.79 ± 3.65). The caries experience amongst children in relation to education of their parents revealed a significant difference (p < 0.001), and the mean dmft score was high amongst preschool children with primary school qualified parents (10.7 ± 4.10) followed by high school (7.04 ± 3.68), vocational (5.81 ± 3.57), diploma (2.61 ± 2.81), and university (1.29 ± 2.27), respectively. The results revealed a valid significant difference (negative correlation, rs = −0.753 **) between the OHL of parents with the dmft score of their preschool children. The age and gender of parents was not significantly associated with OHL, whereas ethnicity (positive correlation, rs = 0.283 **), education (positive correlation, rs = 0.865 **), and employment (negative correlation, rs = −0.490 **) were found to be significant. Conclusion: We conclude that there is a significant association between the OHL of parents with the dmft score of their preschool children. The logistic regression showed that after adjustment for sociodemographic factors, parents’ gender (OR = 0.067, 95% CI: 0.012–0.360), parents’ employment status (OR = 3.247, 95% CI: 0.897–11.754), parents’ OHL score (OR = 0.042, 95% CI: 0.016–0.114), and child age (OR = 2.195, 95% CI: 1.249–3.857) were significantly associated with dental caries in children. Our study concluded that parents’ employment status, age, gender, OHL, and child’s age were significantly associated with the caries experience of their preschool children.

The association between oral health literacy and oral health behaviors in North Korean defectors: a cross-sectional study

BackgroundThe present study aimed to investigate the association between oral health literacy and oral health behaviors among North Korean defectors.MethodsThis study involved the collection of self-reported questionnaires from 123 North Korean defectors visited a dental clinic that offered complimentary services, to receive dental treatment in a metropolitan area of South Korea from December 2017 to April 2018. Oral health literacy was measured with the Test of Korean Functional Health Literacy in Dentistry (TOKFHLiD), which consists of 30 items concerning verbal oral health literacy and 42 items concerning functional oral health literacy (28 items for reading comprehension and 14 items for numeracy). In addition, the questionnaire contains 15 and 14 items related to demographic characteristics and oral health behaviors (interest, lifestyle, diet, prevention), respectively, for a total of 101 items.ResultsThe mean oral health literacy score was 44 (out of a maximum possible score of 72). Oral health literacy and oral health behaviors were positively correlated (r = 0.526, P < 0.001), and oral health literacy also had a significant effect on oral health behaviors (Beta = 0.26, 95% CI: 0.04–0.33). However, although functional oral health literacy had a significant effect on oral health behaviors (Beta = 0.20, 95% CI: 0.01–0.43), verbal oral health literacy did not (Beta = 0.13, 95% CI: − 0.06-037).ConclusionsEducational interventions are needed to improve oral health literacy, and thus oral health behaviors, as a part of the health promotion measures undertaken to facilitate the stable adjustment of North Korean defectors in South Korean society.

Oral Health Literacy and its Relationship with Level of Education and Self: Efficacy among Patients Attending a Dental Rural Outreach Clinic in India

Objective: To evaluate the relationship between Oral health literacy (OHL) with the level of education and self-efficacy among adults (age 18-77 years) patients attending a dental outreach clinic in Udupi Taluk. Basic Research Design: A cross-sectional study of adult patients attending a dental outreach clinic by convenience sampling. Method: Information was obtained about patient’s sociodemographic factors along with the self-efficacy by using Dental Copings Belief’s scale (DCBS) questionnaire and OHL was assessed by using a word recognition instrument Rapid Estimate of Adult Literacy in Dentistry (REALD-30).One way ANOVA and Pearson’s χ2 test were used for analysis. Participants: 200adult patients age range of 18-77 years who wanted to seek dental care in a dental outreach clinic. Main Outcome Measures: Oral health literacy (OHL) and Self efficacy (DCBS). Results: In this study the OHL was significantly associated with the level of education of patients.Among the 200 subjects who claimed to be able to read and write English language andhad completed education till class 10th; more than 50% of the subjects had Low (≤21)OHL scores. Only 12.5% of the total study population had High OHL (≥26) and were clearly able to understand simple dental terminology. Moderate levels of literacy was recorded in 75.6% in graduate and postgraduates indicating that even these people partially understood dental terms. There was no significant association between oral health literacy and selfefficacy. Conclusion: Ourstudy suggests level of education to be a strong indicator of the OHL in the Indian Population. Further research to develop new instruments to measure the OHL, in a culturally diverse country like India, which has people of different mother tongues should be encouraged.

Impact of Oral Health Literacy on Periodontal Health among Low-income-group Workers of Dental Institutes in Patna, Bihar, India

To evaluate the impact of oral health literacy (OHL) on the periodontal health among low-income-group workers of dental institutes. A cross-sectional study was conducted on 137 class III and IV workers of dental college. Data collection was done by using a customized pro forma including demographics, REALD-30 for calculating OHL, and items on oral hygiene habits like toothpaste use, brushing frequency, and any other oral hygiene aid. Following which periodontal health status was determined, which was categorized into severe, moderate, and mild periodontitis (health). The analysis was done using the SPSS 11.5. Periodontal health status was associated with OHL scores, oral hygiene habits, and demographics using the chi-square test. The statistical significance level was set at 5% level. Among the 137 subjects, 25 participants reported health/mild periodontitis, 53 had moderate periodontitis, and 59 had severe periodontitis. Low OHL was observed in 52.5% and only 13.8% had high OHL. The participants who had low OHL, 56.94% (n = 41), were having severe disease, while the subjects who had better OHL, only 21.05% (n = 4) were found to have severe disease. The people with low socioeconomic classes can be reached effectively if the community involvement concept is used through the workers of dental institutions. But first efforts should be made to improve the OHL of these workers. Improving OHL can be of great help to the clinicians and the community health workers because it helps them to make patient adherent to the treatment and the medications prescribed to them. Periodontitis affects people with low socioeconomic status and in the present study it was class III and IV workers. Improving OHL of this population will decrease the oral disease burden of India.

Do Parents’ Oral Health Literacy Levels Influence Their Response to Interventions to Improve Their Knowledge of Traumatic Dental Injuries?

Objective: To measure the influence of oral health literacy (OHL) level in the improvement of knowledge about traumatic dental injuries (TDI) after an educational intervention. Material and Methods: A total of 257 parents of children aged 0–12 years had their OHL level evaluated (BREALD-30). A leaflet with information about how to respond to TDI Emergency was developed and delivered to the parents. A questionnaire about attitudes towards TDI was administered before (TDIQ1) and after (TDIQ2) parents read the educational leaflet. The hypotheses were evaluated by non-parametric tests, correlation analysis and logistic regression . Results: The mean OHL score was 21.6. The means of correct answers in TDIQ1 were 5.5 and 5.9 (p = 0.066) and in TDIQ2 were 6.6 and 7.7 (p=0.003) between the groups with inadequate and marginal/adequate OHL, respectively. In the logistic regression, the total score of BREALD-30 and the maximum number of correct answers in TDIQ2 maintained statistical association when adjusted for schooling, gender, age of the parents, family income and the number of correct answers in the first application of the questionnaire . Conclusion: The level of OHL influenced the improvement of parents’ knowledge about emergency care in cases of TDI in children from an educational intervention using a leaflet, and this intervention was more effective for parents with adequate OHL.

Relationship between Caregivers' Oral Health Literacy and their Child's Caries Experience.

This study aimed to assess the association between caregivers' oral health literacy (OHL) and the dental caries experience of their child. This cross-sectional study was conducted among 300 caregiver/child dyads at a paediatric dental centre in Saudi Arabia. The OHL was assessed using an Arabic translated version of Comprehensive Measure of Oral Health Knowledge (CMOHK-A) questionnaire. Test-retest reliability and internal consistency was assessed using the appropriate statistical methods. Childrens' dental caries experience was assessed using the DMFT and deft index (decayed, missing/extracted, filled teeth) for permanent and primary teeth respectively. The mean age of the caregivers and children was 37.9±7.9 years and 8.3±3.1 years respectively. Most children (87.7%) had dental caries experience (dmft ⟩ 0) and the mean DMFT/deft was 5.2±4.0. The means±standard deviations (SD) for untreated caries (DT/dt), missing/extracted teeth (MT/et) and filled teeth (FT/ft) were 2.6±2.5, 0.5±0.9 and 2.1±2.2 respectively. Multivariate linear regression models showed that caregivers educational levels and OHL scores were associated with the child's untreated caries levels. Caregivers' gender, educational levels and their perception of the child's oral health were significant predictors for child's lifetime caries experience. Children of caregivers with low OHL had more untreated caries than children of caregivers with adequate OHL. This study found better caregiver OHL levels to be associated with lower caries experience for their child.

Oral Health Literacy and Outcomes in Rural Wisconsin Adults.

Low oral health literacy (OHL) is an emerging risk factor for several oral health outcomes, but there are very few studies of OHL overall and no studies of OHL in the rural United States. The purpose of this study was to examine the association between OHL and sociodemographic factors, as well as several oral health outcomes, in rural adults served by an integrated medical and dental care system in Wisconsin. A cross-sectional survey was administered to a stratified random sample of patients from 2 rural communities. Survey data were linked to local electronic health records. Multivariable regression was used to identify sociodemographic determinants of low OHL, as well as associations between OHL and: oral hygiene, oral health quality of life, dentist visits, and emergency/urgent care visits for nontraumatic dental conditions. Among the 164 respondents, OHL scores were generally high but were significantly lower among nonwhite participants (P < .001), as well as those without a college degree (P < .001) and those with an annual household income under $40,000 (P = .029). Lower OHL scores were significantly associated with lower quality of life scores (P = .005), fewer visits to the dentist (P=.007), and more emergency room visits for nontraumatic dental conditions (P = .021). In rural Wisconsin, low OHL tracked closely with markers of socioeconomic status and appeared most influential in the context of appropriate dental care utilization. Future research should consider longitudinal explorations of how OHL influences preventive and emergency dental visits over time.

Relationship between oral health literacy and oral health status

BackgroundHealth literacy has been found to be a strong predictor of an individuals’ health, health behavior and health outcomes. Lower literacy has been linked to problems with the use of preventive services, delayed diagnoses of medical conditions, poor adherence to medical instructions, poor self-management skills, increased mortality risks, poor health outcomes, and higher health care costs. The aim of this study is to determine the relationship between oral health literacy (OHL) and oral health status among patients attending a University-affiliated dental clinic.MethodsA convenience sample of participants was drawn from the dental patients presenting at School of Dental Medicine (SODM), Case Western Reserve University (CWRU). Information about the subjects’ demographic details, income, family size, insurance type and smoking history were collected using a data collection form. Data about the patients’ periodontal and caries risk assessment, caries experience and periodontal status was extracted from the patients’ electronic dental records. The Comprehensive Measure of Oral Health Knowledge (CMOHK) was used to record the oral health literacy. The median CMOHK score was 18, and this was used to categorize the sample into limited OHL (≤18) and adequate OHL (> 18) groups. A multivariate logistic regression model was built to examine the associations between the various independent variables and OHL levels.ResultsData of 150 respondents were analyzed. More than half of the participants were female (55.3%) and the majority were Caucasian (60%). The average age of participants was 53.3 years [standard deviation (SD) 16.8]. Higher percentage of African Americans and individuals with low education had limited OHL levels (p < 0.05). The mean decayed, missing, and filled teeth (DMFT) score for this population was 7.33 ± 2.68. Subjects with limited OHL had significantly higher mean values for missing teeth (p < 0.05) and lower mean values for filled teeth (p < 0.05) as compared with subjects with adequate OHL Significantly, higher percentage of subjects with limited OHL had severe periodontitis as compared with those with adequate OHL (p = 0.04). Multivariate analysis found that the periodontal status was significantly associated with the OHL scores (p = 0.015).ConclusionSubjects with limited OHL levels had poorer periodontal health. Improving the OHL of patients may help in the efforts to improve the adherence to medical instructions, self-management skills and the overall treatment outcomes. Future research could focus on assessing the impact of OHL interventions on the oral health, which could be valuable for clinical practitioners.

Using Interprofessional Education to Promote Oral Health Literacy in a Faculty-Student Collaborative Practice.

The aim of this study was to assess the oral health literacy knowledge gained by patients who are refugees, community members, and medical and nursing students after participating in an interprofessional education collaborative of students and faculty from the University of Texas Health San Antonio Schools of Dentistry, Medicine, and Nursing. In this faculty-student collaborative practice, all patients were triaged (including oral hygiene status and alcohol/tobacco use), and tailored treatment options were offered following assessment of their dental, medical, and social histories. The study was designed as a pre-post assessment of an educational intervention on oral health literacy. In the pretest, all groups were invited to respond to questionnaires assessing their knowledge of oral health. After participants engaged in oral hygiene instruction demonstrations and received information about an oral health literacy campaign, a posttest was conducted to assess knowledge gained. A total of 151 patients who were refugees, 38 medical students, 34 nursing students, and 17 community/parish members voluntarily participated in this initiative. Each group had a significant increase in mean oral health literacy score from pre- to posttest: patients 33.5%, community/parish members 22.3%, nursing students 20.8%, and medical students 13% (all p<0.0001). These results showed that the oral health literacy initiative helped increase all participants' oral health literacy and knowledge of preventive care.

Impact of oral health literacy on self-reported missing data in epidemiological research.

To investigate whether oral health literacy (OHL) impacts missing data obtained through self-reporting in oral health epidemiological research. A cross-sectional study was conducted with parents (n=344) of 4- to 5-year-old children randomly selected from public schools within the city of Curitiba, Brazil. Parental OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Parents answered a set of questionnaires comprising 88 items concerning sociodemographic and economic data, children's access to dental services, oral hygiene behaviour, diet and mealtime behaviour. The total number of unanswered items (TUI) and the number of unanswered items in each type of question (open-ended, dichotomous, multiple choice with up to 4 options and with 5-9 options) for each participant was compared across different levels of OHL (chi-squared, Mann-Whitney, Kruskal-Wallis and Spearman's correlation test). Multiple Poisson regression was used to estimate rate ratios (RR) of TUI between OHL scores and their respective 95% confidence interval (95% CI). Approximately one-third of studied parents (37%) exhibited low OHL (BREALD-30≤21). The prevalence of missing data in at least one item was 85.5%. Low OHL was associated with failing to respond open-ended items (P=0.003) and multiple-choice items with up to 4 (P=0.003) and between 5 and 9 options (P=0.030). There was a negative correlation between OHL scores and TUI (r=-0.195; P<0.001), as well as with the number of unanswered items in all types of questions (P<0.01), except dichotomous questions. Parents with lower OHL were more likely to show higher values of TUI (RR 0.95: 0.93-0.98), when adjusted by income and education. Participants with lower OHL were significantly more likely to fail to complete research questionnaires. The impact of OHL on missing data was greater with more complex types of items.

The impact of anticipatory guidance on early childhood caries: a quasi-experimental study

BackgroundThis study evaluated the impact of anticipatory guidance on the caries incidence of 2–3-year-old preschool children and their 4–6-year-old siblings, as well as on their mothers’ oral health literacy, as compared to the conventional Ministry of Health (MOH) programme.MethodsThis quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother’s oral health literacy was assessed after 3 years of intervention.ResultsChildren and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2–3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p < 0.05). At three-year follow-up, there were significant increments in the oral health literacy scores of mothers in the intervention group compared to the control group.ConclusionThe FDWP is more effective than the standard MOH programme in terms of children’s and siblings’ caries incidence and mother’s oral health literacy.Trial registrationClinicalTrials.gov NCT03478748. Registered on March 26th 2018. Retrospectively registered.

Oral health literacy and its determinants among adults in Southeast Iran.

Objectives:The present study aimed to assess oral health literacy level and its related factors among adult patients visiting Kerman Dental School.Materials and Methods:This cross-sectional study was conducted in Kerman Dental School clinic, among the first-time adult visitors. Individuals were selected randomly from volunteers who signed study consent forms. Background information and oral health literacy levels were acquired through the oral health literacy-adult questionnaire. Statistical analysis including the Chi-square test and independent t-test served for statistical evaluation of the study data.Results:Participants were 264 adults which consisted of 72.3% women and the mean age of 37 ± 8 years old. The mean oral health literacy score was 12.07 (out of 17), and 62.5% of the participants had an adequate oral health literacy level. There was a significant relationship between oral health literacy scores with gender, high level of education, and oral health behavior.Conclusion:The study participants had a good level of oral health literacy which can be correlated with their educational status and oral health information sources. An oral health educational program for less educated people is recommended.

Association of oral health behavior and the use of dental services with oral health literacy among adults in Tehran, Iran.

Objective:To assess the association of oral health behavior (OHB) and the use of dental services with oral health literacy (OHL) among Iranian adults.Methods:This was a cross-sectional population study of a random sample of 1031 adults aged 18–65 in Tehran, Iran. We collected data on tooth brushing frequency, the consumption of sugary snacks and beverages, and time since last dental visit. To measure OHL, we used a validated OHL adults’ questionnaire (OHL-AQ). In addition to descriptive analysis, we used multiple logistic regression models to assess the association of OHB and the most recent dental visit with OHL while controlling for socioeconomic and demographic factors.Results:The participants’ mean age was 36.3 (standard deviation 12.9), and 51% were women. Of the participants, 81.3% reported brushing their teeth daily (≥1/day), 37.6% consumed sugary snacks or beverages between meals less than once daily (<1/day), and 36.8% used dental services within the past 6 months. In the adjusted models, high OHL scores significantly correlated with daily (≥1/day) tooth brushing (odds ratio [OR] = 1.97, 95% confidence interval [CI]: 1.30–2.98), the consumption of sugary snacks or beverages (<1/day between meals) (OR = 1.56, 95% CI: 1.13–2.15) and the recent use of dental services (≤6 months) (OR = 1.59, 95% CI: 1.15–2.21), respectively.Conclusions:OHL relates significantly to improved OHB and the use of dental services. Oral health promotion programs should, therefore, take into account improvements in adults’ OHL, particularly in countries with developing health-care services.