The relationship between health literacy and caries experience among patients at a university dental clinic

Aims: This study evaluated whether caries experience varied with general health literacy among patients receiving care at a university dental clinic; literacy was measured with the Turkish Health Literacy Scale-32 (THLS-32). Methods: This cross-sectional study consecutively enrolled 130 patients aged 16 years or older from October 2021 to January 2022. Caries experience was quantified with the decayed, missing, and filled teeth (DMFT) Index. Unadjusted associations were examined using Spearman’s rho; multivariable Poisson regression assessed the THLS-32 total score in relation to DMFT, controlling for age, gender, education level, and self-perceived income level. Results: Among participants with a valid THLS-32 total score (n=122), the mean score was 34.80±8.62, and 41.8% had inadequate or problematic-limited health literacy. Median (Q1-Q3) values were 9 (6-12) for total DMFT, 3 (1-5) for decayed teeth, 2 (0-6) for missing teeth, and 2 (0-4) for filled teeth. The THLS-32 total score showed no significant unadjusted correlation with DMFT (ρ=0.060, 95% CI: -0.125 to 0.240; p=0.514). Adjusted analysis indicated a slight increase in DMFT with higher THLS-32 total scores (IRR=1.008, 95% CI: 1.001-1.014; p=0.027). Among the individual DMFT components, a significant adjusted association was observed only for missing teeth (IRR=1.016, 95% CI: 1.006-1.026; p=0.002). Conclusion: General health literacy was not significantly correlated with DMFT before adjustment, but a small positive association appeared after covariate adjustment. Among the DMFT components, only missing teeth showed a significant adjusted association.