Oral Health Literacy: Decision-Making and Reading Comprehension Skills as the Determinants of Self-Reported Oral Health
,
Abstract
Objectives: Oral health literacy (OHL) is a concept far beyond reading and including other skills such as numeracy skills, listening, and decision-making. Self-reported oral health(SROH) is a reliable and cost-effective measure of dental and periodontal conditions. The current study aimed to evaluate the association between various aspects of OHL and SROH.
Materials and Methods: This cross-sectional study was conducted among adults visiting a dental school. One interviewer asked each individual ”How would you describe your oral health at present?” to measure SROH. Two response categories were “good” and “poor”. OHL-AQ (Oral Health Literacy Adult Questionnaire) was used to measure different aspects of OHL (Reading comprehension and knowledge, listening, numeracy and communication, and decision-making skills). The total scores ranged from 0 and 17. To analyze the data binary logistic regression and chi-square tests were performed. (P=0.05)
Results: Totally 253 adults participated. Most participants (65.21%) were females. The numbers of subjects with good and poor SROH were 127(50.20%) and 126(49.80%) respectively. The mean age of the participants was 37.75±10.69 years and ranged from 18 to 65 years. The overall mean OHL score was 11.74±3.12. Out of the components of OHL in OHL-AQ, reading comprehension and knowledge skills (p=0.032), and decision-making skills (p=0.013) had a significant positive correlation with good SROH. In contrast, listening (p=0.955) and numeracy skills (p=0.349) did not exhibit a similar association.
Conclusion: OHL level, particularly decision-making, reading comprehension, and knowledge skills, is associated with SROH.
1. National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services. The invisible barrier: literacy and its relationship with oral health. A report of a workgroup sponsored by the National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services. J Public Health Dent. 2005 Summer;65(3):174-82.
2. Sun Y, Li C, Zhao Y, Sun J. Trends and developments in oral health literacy: a scientometric research study (1991-2020). BDJ Open. 2021 Mar 1;7(1):13.
3. Health Literacy. Available at: https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/health-literacy/ Accessed November 30, 2023.
4. Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Oral health literacy and information sources among adults in Tehran, Iran. Community Dent Health. 2013 Sep;30(3):178-82.
5. Fazli M, Yazdani R, Mohebbi SZ, Shamshiri AR. Oral Health Literacy and Its Determinants in Young Couples. Front Dent. 2023 Jul 26;20:27.
6. Fazli M, Yazdani R, Mohebbi SZ, Shamshiri AR. Oral health literacy and socio-demographics as determinants of oral health status and preventive behavior measures in participants of a pre-marriage counseling program. PLoS One. 2021 Nov 5;16(11):e0258810.
7. Mohammadi TM, Malekmohammadi M, Hajizamani HR, Mahani SA. Oral health literacy and its determinants among adults in Southeast Iran. Eur J Dent. 2018 Jul-Sep;12(3):439-442.
8. Navabi N, Najminouri F, Tavallaie M. Assessment of oral health literacy: A systematic review of validated worldwide versus Persian measures. J Oral Health Oral Epi. 2020 Jan 1;9(1):7-15.
9. Zamanzadeh M, Mahmoodnia E, Moosazadeh M, Ghorbani A. Evaluation of Oral Health Literacy among Adults in Sari-Iran. Pak J Med. 2021 Jun 30;15(6):2084–8.
10. Horowitz AM, Kleinman DV. Oral health literacy: a pathway to reducing oral health disparities in Maryland. J Public Health Dent. 2012 Winter;72 Suppl 1:S26-30.
11. J Public Health England and UCL Institute for Health Equity. Local action on health inequalities: improving health literacy to reduce health inequalities. 2015. Available at: https://assets.publishing.service.gov.uk/media/5a80b62d40f0b62302695133/4b_Health_Literacy-Briefing.pdf/ Accessed November 30, 2023.
12. Sabbahi DA, Lawrence HP, Limeback H, Rootman I. Development and evaluation of an oral health literacy instrument for adults. Community Dent Oral Epidemiol. 2009 Oct;37(5):451-62.
13. Jones M, Lee JY, Rozier RG. Oral health literacy among adult patients seeking dental care. J Am Dent Assoc. 2007 Sep;138(9):1199-208; quiz 1266-7.
14. Palumbo R. Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review. Int J Health Policy Manag. 2015 May 13;4(7):417-30.
15. Naghibi Sistani MM, Montazeri A, Yazdani R, Murtomaa H. New oral health literacy instrument for public health: development and pilot testing. J Investig Clin Dent. 2014 Nov;5(4):313-21.
16. Naghibi Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Determinants of oral health: does oral health literacy matter? ISRN Dent. 2013;2013:249591.
17. Blicher B, Joshipura K, Eke P. Validation of self-reported periodontal disease: a systematic review. J Dent Res. 2005 Oct;84(10):881-90.
18. Buhlin K, Gustafsson A, Andersson K, Håkansson J, Klinge B. Validity and limitations of self-reported periodontal health. Community Dent Oral Epidemiol. 2002 Dec;30(6):431-7.
19. Pinelli C, de Castro Monteiro Loffredo L. Reproducibility and validity of self-perceived oral health conditions. Clin Oral Investig. 2007 Dec;11(4):431-7.
20. Pitiphat W, Garcia RI, Douglass CW, Joshipura KJ. Validation of self-reported oral health measures. J Public Health Dent. 2002 Spring;62(2):122-8.
21. Ramos RQ, Bastos JL, Peres MA. Diagnostic validity of self-reported oral health outcomes in population surveys: literature review. Rev Bras Epidemiol. 2013 Sep;16(3):716-28. English, Portuguese.
22. Bond JC, Casey SM, McDonough R, McLone SG, Velez M, Heaton B. Validity of individual self-report oral health measures in assessing periodontitis for causal research applications. J Periodontol. 2024 Sep;95(9):892-906.
23. Parker EJ, Jamieson LM. Associations between indigenous Australian oral health literacy and self-reported oral health outcomes. BMC Oral Health. 2010 Mar 26;10:3.
24. Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Stat Med. 1998 Jul 30;17(14):1623-34
25. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health. 2011 Feb 7;10:9.
26. Maudi T, Suryanti N, Setiawan AS. Relationship between mother’s oral health literacy level with oral hygiene behavior and self-reported oral health status in sociodemographic scope. Padjadjaran J Dent. 2023 Apr 5;35(1):40-6.
27. Haerian Ardakani A, Morowatisharifabad M, Rezapour Y, Pourghayumi Ardakani A. Investigation of the Relationship of Oral Health lteracy and Oral hygiene Self-Efficacy with Self-Reported Oral and Dental Health in Students. Toloo-e-behdasht. 2015 Jan 1;13(5).
28. Carvalho C, Manso AC, Escoval A, Salvado F, Nunes C. Self-perception of oral health in older adults from an urban population in Lisbon, Portugal. Rev Saude Publica. 2016 Aug 22;50:53.
29. Ekanayke L, Perera I. Factors associated with perceived oral health status in older individuals. Int Dent J. 2005 Feb;55(1):31-7.
30. Martins AB, Dos Santos CM, Hilgert JB, de Marchi RJ, Hugo FN, Pereira Padilha DM. Resilience and self-perceived oral health: a hierarchical approach. J Am Geriatr Soc. 2011 Apr;59(4):725-31.
31. Dahl KE, Calogiuri G, Jönsson B. Perceived oral health and its association with symptoms of psychological distress, oral status and socio-demographic characteristics among elderly in Norway. BMC Oral Health. 2018 May 31;18(1):93.
32. Ugarte J, Abe Y, Fukuda H, Honda S, Takamura N, Kobuke Y, et al. Self-perceived oral health status and influencing factors of the elderly residents of a peri-urban area of La Paz, Bolivia. Int Dent J. 2007 Feb;57(1):19-26.
33. Moon JH, Heo SJ, Jung JH. Factors Influencing Self-Rated Oral Health in Elderly People Residing in the Community: Results from the Korea Community Health Survey, 2016. Osong Public Health Res Perspect. 2020 Aug;11(4):245-250.
34. Chantaraboot Y, Sermsuti-Anuwat N. Factors Associated with Self-reported Oral Health Among Community-Dwelling Older Adults in a Rural Province of Thailand. J Multidiscip Healthc. 2022 Sep 21;15:2111-2119.
35. Lee JY, Rozier RG, Lee SY, Bender D, Ruiz RE. Development of a word recognition instrument to test health literacy in dentistry: the REALD-30--a brief communication. J Public Health Dent. 2007 Spring;67(2):94-8.
36. Gong DA, Lee JY, Rozier RG, Pahel BT, Richman JA, Vann WF Jr. Development and testing of the Test of Functional Health Literacy in Dentistry (TOFHLiD). J Public Health Dent. 2007 Spring;67(2):105-12.
37. Muller R. Does an oral health education program increase oral health literacy and access to dental care in a refugee population? [thesis]. Eastern Washington University; 2016.
38. Farokhi MR, Muck A, Lozano-Pineda J, Boone SL, Worabo H. Using Interprofessional Education to Promote Oral Health Literacy in a Faculty-Student Collaborative Practice. J Dent Educ. 2018 Oct;82(10):1091-1097.literacy and self-reported oral health outcomes. BMC Oral Health. 2010 Dec 26;10(1):3.
2. Sun Y, Li C, Zhao Y, Sun J. Trends and developments in oral health literacy: a scientometric research study (1991-2020). BDJ Open. 2021 Mar 1;7(1):13.
3. Health Literacy. Available at: https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/health-literacy/ Accessed November 30, 2023.
4. Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Oral health literacy and information sources among adults in Tehran, Iran. Community Dent Health. 2013 Sep;30(3):178-82.
5. Fazli M, Yazdani R, Mohebbi SZ, Shamshiri AR. Oral Health Literacy and Its Determinants in Young Couples. Front Dent. 2023 Jul 26;20:27.
6. Fazli M, Yazdani R, Mohebbi SZ, Shamshiri AR. Oral health literacy and socio-demographics as determinants of oral health status and preventive behavior measures in participants of a pre-marriage counseling program. PLoS One. 2021 Nov 5;16(11):e0258810.
7. Mohammadi TM, Malekmohammadi M, Hajizamani HR, Mahani SA. Oral health literacy and its determinants among adults in Southeast Iran. Eur J Dent. 2018 Jul-Sep;12(3):439-442.
8. Navabi N, Najminouri F, Tavallaie M. Assessment of oral health literacy: A systematic review of validated worldwide versus Persian measures. J Oral Health Oral Epi. 2020 Jan 1;9(1):7-15.
9. Zamanzadeh M, Mahmoodnia E, Moosazadeh M, Ghorbani A. Evaluation of Oral Health Literacy among Adults in Sari-Iran. Pak J Med. 2021 Jun 30;15(6):2084–8.
10. Horowitz AM, Kleinman DV. Oral health literacy: a pathway to reducing oral health disparities in Maryland. J Public Health Dent. 2012 Winter;72 Suppl 1:S26-30.
11. J Public Health England and UCL Institute for Health Equity. Local action on health inequalities: improving health literacy to reduce health inequalities. 2015. Available at: https://assets.publishing.service.gov.uk/media/5a80b62d40f0b62302695133/4b_Health_Literacy-Briefing.pdf/ Accessed November 30, 2023.
12. Sabbahi DA, Lawrence HP, Limeback H, Rootman I. Development and evaluation of an oral health literacy instrument for adults. Community Dent Oral Epidemiol. 2009 Oct;37(5):451-62.
13. Jones M, Lee JY, Rozier RG. Oral health literacy among adult patients seeking dental care. J Am Dent Assoc. 2007 Sep;138(9):1199-208; quiz 1266-7.
14. Palumbo R. Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review. Int J Health Policy Manag. 2015 May 13;4(7):417-30.
15. Naghibi Sistani MM, Montazeri A, Yazdani R, Murtomaa H. New oral health literacy instrument for public health: development and pilot testing. J Investig Clin Dent. 2014 Nov;5(4):313-21.
16. Naghibi Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Determinants of oral health: does oral health literacy matter? ISRN Dent. 2013;2013:249591.
17. Blicher B, Joshipura K, Eke P. Validation of self-reported periodontal disease: a systematic review. J Dent Res. 2005 Oct;84(10):881-90.
18. Buhlin K, Gustafsson A, Andersson K, Håkansson J, Klinge B. Validity and limitations of self-reported periodontal health. Community Dent Oral Epidemiol. 2002 Dec;30(6):431-7.
19. Pinelli C, de Castro Monteiro Loffredo L. Reproducibility and validity of self-perceived oral health conditions. Clin Oral Investig. 2007 Dec;11(4):431-7.
20. Pitiphat W, Garcia RI, Douglass CW, Joshipura KJ. Validation of self-reported oral health measures. J Public Health Dent. 2002 Spring;62(2):122-8.
21. Ramos RQ, Bastos JL, Peres MA. Diagnostic validity of self-reported oral health outcomes in population surveys: literature review. Rev Bras Epidemiol. 2013 Sep;16(3):716-28. English, Portuguese.
22. Bond JC, Casey SM, McDonough R, McLone SG, Velez M, Heaton B. Validity of individual self-report oral health measures in assessing periodontitis for causal research applications. J Periodontol. 2024 Sep;95(9):892-906.
23. Parker EJ, Jamieson LM. Associations between indigenous Australian oral health literacy and self-reported oral health outcomes. BMC Oral Health. 2010 Mar 26;10:3.
24. Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Stat Med. 1998 Jul 30;17(14):1623-34
25. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health. 2011 Feb 7;10:9.
26. Maudi T, Suryanti N, Setiawan AS. Relationship between mother’s oral health literacy level with oral hygiene behavior and self-reported oral health status in sociodemographic scope. Padjadjaran J Dent. 2023 Apr 5;35(1):40-6.
27. Haerian Ardakani A, Morowatisharifabad M, Rezapour Y, Pourghayumi Ardakani A. Investigation of the Relationship of Oral Health lteracy and Oral hygiene Self-Efficacy with Self-Reported Oral and Dental Health in Students. Toloo-e-behdasht. 2015 Jan 1;13(5).
28. Carvalho C, Manso AC, Escoval A, Salvado F, Nunes C. Self-perception of oral health in older adults from an urban population in Lisbon, Portugal. Rev Saude Publica. 2016 Aug 22;50:53.
29. Ekanayke L, Perera I. Factors associated with perceived oral health status in older individuals. Int Dent J. 2005 Feb;55(1):31-7.
30. Martins AB, Dos Santos CM, Hilgert JB, de Marchi RJ, Hugo FN, Pereira Padilha DM. Resilience and self-perceived oral health: a hierarchical approach. J Am Geriatr Soc. 2011 Apr;59(4):725-31.
31. Dahl KE, Calogiuri G, Jönsson B. Perceived oral health and its association with symptoms of psychological distress, oral status and socio-demographic characteristics among elderly in Norway. BMC Oral Health. 2018 May 31;18(1):93.
32. Ugarte J, Abe Y, Fukuda H, Honda S, Takamura N, Kobuke Y, et al. Self-perceived oral health status and influencing factors of the elderly residents of a peri-urban area of La Paz, Bolivia. Int Dent J. 2007 Feb;57(1):19-26.
33. Moon JH, Heo SJ, Jung JH. Factors Influencing Self-Rated Oral Health in Elderly People Residing in the Community: Results from the Korea Community Health Survey, 2016. Osong Public Health Res Perspect. 2020 Aug;11(4):245-250.
34. Chantaraboot Y, Sermsuti-Anuwat N. Factors Associated with Self-reported Oral Health Among Community-Dwelling Older Adults in a Rural Province of Thailand. J Multidiscip Healthc. 2022 Sep 21;15:2111-2119.
35. Lee JY, Rozier RG, Lee SY, Bender D, Ruiz RE. Development of a word recognition instrument to test health literacy in dentistry: the REALD-30--a brief communication. J Public Health Dent. 2007 Spring;67(2):94-8.
36. Gong DA, Lee JY, Rozier RG, Pahel BT, Richman JA, Vann WF Jr. Development and testing of the Test of Functional Health Literacy in Dentistry (TOFHLiD). J Public Health Dent. 2007 Spring;67(2):105-12.
37. Muller R. Does an oral health education program increase oral health literacy and access to dental care in a refugee population? [thesis]. Eastern Washington University; 2016.
38. Farokhi MR, Muck A, Lozano-Pineda J, Boone SL, Worabo H. Using Interprofessional Education to Promote Oral Health Literacy in a Faculty-Student Collaborative Practice. J Dent Educ. 2018 Oct;82(10):1091-1097.literacy and self-reported oral health outcomes. BMC Oral Health. 2010 Dec 26;10(1):3.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Original Article | |
| Keywords | ||
| Health literacy Oral Health Self-Assessment | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Ebrahimi N, Sargeran K, Yazdani R. Oral Health Literacy: Decision-Making and Reading Comprehension Skills as the Determinants of Self-Reported Oral Health. Front Dent. 2025;22.
