Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic

Objectives: This study aimed to determine the association between oral health literacy (OHL), oral health status (OHS), and utilization of dental services among maintenance patients.

Methods: The study design was a cross-sectional study. Participants were maintenance patients attending the Comprehensive Dental Clinic, Faculty of Dentistry, Chiang Mai University from January to April 2021. Information about the participant’s demographic details, including education, and income were collected using a questionnaire. The Decayed-Missing-Filled Teeth index (DMFT), Plaque Index (PI), and utilization of dental service were obtained from the electronic dental record. OHL was assessed using the Thai Version of Rapid Estimate of Adult Literacy in Dentistry (ThREALD-30). Data were analyzed using Spearman correlation and binary logistic regression.

Results: A total of 130 participants were recruited for this study. The mean age of participants was 51.1 years. The mean ThREALD-30 score was 26.7±3.76. The OHL scores were significantly negatively correlated with DMFT (r=-0.356; p= 0.002), PI (r=-0.398; p<0.001), and utilization of dental services (r=-0.35, p<0.001). After adjusting for age, gender, education and income, OHL was significantly associated with DMFT (OR=1.36; p=0.001), and PI (OR=1.26; p=0.006).

Conclusions: OHL was associated with OHS. Patients with high OHL had good OHS with regular annual dental examinations. An understanding of the OHL of patients is crucial for designing effective oral health education and creating intervention programs to promote oral health

1. Jin LJ, Lamster IB, Greenspan JS, Pitts NB, Scully C, Warnakulasuriya S. Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis. 2016;22(7):609-19.

2. Hayes A, Azarpazhooh A, Dempster L, Ravaghi V, Quinonez C. Time loss due to dental problems and treatment in the Canadian population: analysis of a nationwide cross-sectional survey. BMC Oral Health. 2013;13:17.

3.Jansson H, Wahlin Å, Johansson V, Akerman S, Lundegren N, Isberg P-E, et al. Impact of periodontal disease experience on oral health related quality of life. J Periodontal. 2014;85(3):438-45.

4.Richardson B, Richardson J. End the Decay: The cost of poor dental health and whatshould be done about it. Fitzroy, Melbourne: Brotherhood of St Laurence; 2011.

5.Fejerskov O, Kidd E. Dental caries: the disease and its clinical management. 2nd ed. Oxford Blackwell publishing Ltd; 2009.

6.Cappelli, David P, Connie CM. Prevention in clinical oral health care. St. Louis, Mo: Mosby Elsevier; 2008.

7.Hiremath SS. Textbook of prevention and community dentistry. New Delhi, Elsevier; 2007.

8. 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; 65(3):174-82.

9.Wanichsaithong P, Goodwin M.Pretty IA. Oral health status of Thai older adults with different oral health literacy levels. CM Dent J. 2021; 42(2):104-13.

10. Berkman ND,.SheridanSL, Donahue KE , Halpern DJ, and Crotty K. Low health literacy and health outcomes: An updated systematic review. Ann Intern Med. 2011;155:97-107.

11. Jones M, Lee JY, Rozier RG. Oral health literacy among adult patients seeking dental care. J m Dental Assoc. 2007;138(9):1199-1208.

12. 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.

13. Paasche-Orlow MK, Wolf MS. The causal pathways linking health literacy to health outcomes. Am J Health Behav. 2007; 31(suppl 1):S19-S26.

14. Kesavan R, Prabhakar R, Chaly P, Saravanan R, Mary A. V. Assessment of oral health literacy and Its relationship with oral health related behaviour and socioeconomic status among students of A University in Chennai City. Biomed Pharmacol J. 2019;12(2):739-46.

15. Tirakanant S. Using statistics in social science research: Guidelines for practice. Bangkok: Chulalongkorn University Printing House, 2546.

16. Deeraksa S, Chaichit R, Muktabhant B, Udompanich S. Reliability and validity of the Thai version of rapid estimate of adult literacy in dentistry. J Int Oral Health. 2019;11:132-6.

17.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; 67(2):94-98.

18. World Health Organization . Oral health surveys: basic methods 5ed. FRANCE, 2013.

19.Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975; 25(4):229-35.

20.Wanichsaithong P, Goodwin M, Pretty IA. Development and pilot study of an oral health literacy tool for older adults. J Investig Clin Dent. 2019;10(4):e12465.

21.Haridas R, Supreetha S, Ajagannanavar SL, Tikare S, Maliyil MJ, Kalappa AA. Oral health literacy and oral health status among adults attending dental college hospital in India. J Int Oral Health. 2014; 6(6):61-66.

22. Blizniuk A, Ueno M, Zaitsu T, Kawaguchi Y. Association of oral health literacy with oral health behaviour and oral health status in Belarus. Community Dent Health. 2015;32(3):148–52.

23. Dutra LC, Lima LCM, Neves ETB, Gomes MC, Araújo LJS, Forte FDS, et al. Adolescents with worse levels of oral health literacy have more cavitated carious lesions. PLoS One. 2019; 14(11):e0225176. PMID: 31774850.

24. Batista MJ, Lawrence HP, Sousa M. Oral health literacy and oral health outcomes in an adult population in Brazil. BMC Public Health. 2017; 18(1): 60.

25. Baskaradoss JK. The association between oral health literacy and missed dental appointments. J Am Dent Assoc. 2016;147(11):867–74.

26.Ueno M, Takeuchi S, Oshiro A, Kawaguchi Y. Relationship between oral health literacy and oral health behaviors and clinical status in Japanese adults. J Dent Sci. 2013; 8(2):170–176.

27.Wehmeyer MM, Corwin CL, Guthmiller JM, Lee JY. The impact of oral health literacy on periodontal health status. J Public Health Dent. 2014;74(1):80–7.

28. Jamieson LM, Divaris K, Parker EJ, Lee JY. Oral health literacy comparisons between Indigenous Australians and American Indians. Community Dent Health. 2013; 30(1):52–57.

29.Burgette JM, Lee JY, Baker AD, Vann WF, Jr. Is dental utilization associated with oral health literacy?. J Dent Res. 2016; 95(2): 160-6.

30.Bureau of Dental Public Health. The 8th National Oral Health Survey 2017 of Thailand. Bangkok: Department of Health; 2018.

31.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;67(2):105-12.

Chaisombat M, Kootrakul B, Wanichsaithong P, Chatiketu P. Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic: Original articles. CM Dent J [Internet]. 2023 Jul 05 [cited 2024 Jul 15];44(2):34-41. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=201

Chaisombat, M., Kootrakul, B., Wanichsaithong, P. & Chatiketu, P. (2023). Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic. CM Dent J, 44(2), 34-41. Retrieved from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=201

Chaisombat, M., Kootrakul Boriboon ,Wanichsaithong Pinpinut and Chatiketu Piyanart. 2023. "Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic." CM Dent J, 44(2), 34-41. https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=201

Chaisombat, M. et al. 2023. 'Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic', CM Dent J, 44(2), 34-41. Retrieved from https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=201

Chaisombat, M., Kootrakul, B., Wanichsaithong, P. and Chatiketu, P. "Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic", CM Dent J, vol.44, no. 2, pp. 34-41, Jul. 2023.

Chaisombat, M., Kootrakul, B., Wanichsaithong, P., et al. "Associations Between Oral Health Literacy and Oral Health Status Among Patients Attending Comprehensive Dental Clinic." CM Dent J, vol.44, no. 2, Jul. 2023, pp. 34-41, https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=201