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.
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