Evaluation of Oral Health Literacy Level and Oral Health-Related Quality of Life in Patients Admitted to a University Hospital

Year 2025, Volume: 32 Issue: 4, 309 - 317, 01.12.2025

Özge Arslangiray , Muhammed Fatih Önsüz , Alaettin Ünsal , Onur Er , Elif Aysen Yanık Ertuğrul Onur Karaca Cemile Ezgi Basu Eymen Avcı Fatima Talantbekova Ruhat Sarper Eylül Dinç İsmail Berkay Elma Dilan Aşasın Zahra İbadova Mirmehemmed İsayev

https://doi.org/10.17343/sdutfd.1721498

Abstract

Objective: Oral health literacy (OHL) plays a crucial role in improving individuals’ quality of life by promoting preventive oral and dental health behaviors and raising awareness. This study aimed to investigate the association between OHL levels and oral health-related quality of life (OHRQoL) among adults attending a university hospital.
Material and Method: A total of 423 participants and their relatives aged 18 and over, who attended Eskişehir Osmangazi University Health Practice and Research Hospital between May- July 2024, were included in this cross-sectional investigation. Data were collected using a questionnaire form that included questions about participants' sociodemographic characteristics, oral and dental health behaviors, the Health Literacy Dental Scale-Short Form (HeLD-14), and the Oral Health Impact Profile (OHIP-14). Statistical analyses were performed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman’s correlation, and multivariate linear regression analysis, with a significance threshold set at p<0.05.
Results: The mean scores for HeLD-14 and OHIP-14 among the participants were 43.59 ± 11.45 and 11.30 ± 9.8, respectively. Multivariate linear regression analysis revealed that living in the urban center, having health insurance, reporting good oral health status, and engaging in regular tooth brushing at least once daily and using dental floss were significantly associated with higher OHL levels. A weak negative correlation was observed between HeLD-14 and OHIP-14 scores, indicating that better OHL was associated with an improved OHRQoL.
Conclusion: The study determined that the participants' OHL levels were moderate. Higher OHL levels are associated with more positive health behaviors and better OHRQoL. To improve OHL in the community, it is recommended to raise awareness about oral and dental health through primary healthcare facilities and social media, and to disseminate educational programs using brochures, videos, infographics, and other educational materials.

Keywords

Oral health literacy , Oral health , Quality of life , Oral health behaviors , Cross-sectional

Ethical Statement

Approval for the conduct of this study was obtained from the Eskişehir Osmangazi University (ESOGU) Non-Interventional Clinical Research Ethics Committee (dated May 2, 2024; approval no: E-25403353-050.99-2400082849), and the necessary written permissions were also obtained from the hospital’s chief physician. The study was conducted in accordance with the principles set forth in the Declaration of Helsinki.

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

References

• 1) WHO. Summary reports on proceedings, minutes, and final acts of the ınternational health conference held in New York from 19 June to 22 July 1946 [internet]. World Health Organization; 1948 [Access date: 10.03.2025]. Available from: https://apps.who.int/iris/handle/10665/85573
• 2) WHO. Oral health: achieving better oral health as part of the universal health coverage and noncommunicable disease agendas towards 2030 [internet]. World Health Organization; 2020 [Access date: 10.03.2025]. Available from: https://apps.who.int/gb/ebwha/pdf_files/EB148/B148_8-en.pdf
• 3) Kridaningrat BB, Soegyanto AI, Wimardhani YS. Correlation of oral health literacy with demographic factors and oral hygiene among the elderly. J İnt Med Res. 2017;(10):460–4.
• 4) WHO. Health Literacy [Internet]. World Health Organization; 2024 [Access date: 10.03.2025]. Available from: https://www.who.int/news-room/fact-sheets/detail/health-literacy
• 5) Ameri̇can Dental Associ̇ati̇on. Health literacy in dentistry [internet]. Ameri̇can Dental Associ̇ati̇on; 2010 [Access date: 10.03.2025]. Available from: https://www.ada.org/resources/community-initiatives/health-literacy-in-dentistry
• 6) Bado FMR, De Checchi MHR, Cortellazzi KL, et al. Oral health literacy, self-rated oral health, and oral health-related quality of life in Brazilian adults. Eur J Oral Sci. 2020;128(3):218–25.
• 7) Baskaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health. 2018;18:1–6.
• 8) Mialhe FL, Santos BL, Bado FMR, et al. Association between oral health literacy and dental outcomes among users of primary healthcare services. Braz Oral Res. 2022;36:e004.
• 9) National Institute of Dental and Craniofacial Research. Oral health in America: A Report of the Surgeon General [internet]. National Institute of Dental and Craniofacial Research; 2000 [Access date: 10.03.2025]. Available from: https://www.nidcr.nih.gov/sites/default/files/2017-10/hck1ocv.%40www.surgeon.fullrpt.pdf
• 10) Yu S, Huang S, Song S, et al. Impact of oral health literacy on oral health behaviors and outcomes among the older adults: A scoping review. BMC Geriatr. 2024;24(1):858.
• 11) Das D, Menon I, Gupta R, et al. Impact of oral health literacy on the quality of life among adult population of Ghaziabad District–A hospital-based cross-sectional study. J Indian Assoc Public Health Dent. 2023;21(2):168–73.
• 12) Aydin ÇY, Okyay P. Adaptation of short form of the oral and dental health literacy scale to the Turkish language. Estüdam Halk Sağlığı Derg. 2024;9(1):80–91.
• 13) Güner ÖE, Çilingiroğlu N. Ağız ve diş sağlığı okuryazarlığı nasıl ve hangi boyutlarda ölçülüyor? [How is oral health literacy measured, and in which dimensions?]. Turkish Journal of Health Literacy. 2021;2(2):144–155. Turkish.
• 14) Beşiroğlu E, Lütfioğlu M. Ağız diş sağlığının yaşam kalitesine etkisi ve yaygın değerlendirme yöntemleri. [The effect of oral health on quality of life and commonly used assessment methods]. Journal of International Dental Sciences. 2018;2:81–9. Turkish.
• 15) Jones K, Parker E, Mills H, et al. Development and psychometric validation of a Health Literacy in Dentistry scale (HeLD). Community Dent Health. 2014;31(1):37–43.
• 16) Jones K, Brennan D, Parker E, et al. Development of a short-form Health Literacy Dental scale (HeLD-14). Community Dent Oral Epidemiol. 2015;43(2):143–51.
• 17) Slade GD, Spencer AJ. Development and evaluation of the oral health impact profile. Community Dent Health. 1994;11(1):3–11.
• 18) Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25(4):284–90.
• 19) Mumcu G, Inanc N, Ergun T, et al. Oral health related quality of life is affected by disease activity in Behcet's disease. Oral Dis. 2006;12(2):145–51.
• 20) Firmino RT, Martins CC, Faria LDS, et al. Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment-related outcomes: A systematic review and meta-analysis. J Public Health Dent. 2018;78(3):231–45
• 21) Yilmaz M, Gürsel M. Yaşlanmanın ağız sağlığı ve yaşam kalitesi üzerine etkisi. [The effect of aging on oral health and quality of life]. Turkiye Klinikleri Periodontology - Special Topics. 2022;8(3):20–5. Turkish.
• 22) Murakami K, Aida J, Kuriyama S, et al. Associations of health literacy with dental care use and oral health status in Japan. BMC Public Health. 2023;23(1):1074.
• 23) McCarlie VW Jr, Phillips ME, Price BD, et al. Orthodontic and oral health literacy in adults. PLOS One. 2022;17(8):e0273328.
• 24) Batista MJ, Lawrence HP, Sousa MDLR. Oral health literacy and oral health outcomes in an adult population in Brazil. BMC Public Health. 2018;18:1–9.
• 25) Sukhabogi JR, Doshi D, Vadlamani M, et al. Association of oral health literacy with oral health behavior and oral health outcomes among adult dental patients. Indian J Dent Res. 2020;31(6):835–9.
• 26) Prasanna JS, Karunakar P, Sravya MVN, et al. Detrimental consequences of women life cycle on the oral cavity. Journal of Oral Research and Review. 2018;10(1):39–44.
• 27) Mohammadi TM, Malekmohammadi M, Hajizamani HR, et al. Oral health literacy and its determinants among adults in Southeast Iran. Eur J Dent. 2018;12(3):439–42.
• 28) Noor NM, Rani H, Zakaria ASI, et al. Sociodemography, oral health status and behaviours related to oral health literacy. Pesqui Bras Odontopediatria Clín Integr. 2019;19:e5109.
• 29) Lee CJ, Ho MH, Joo JY, et al. Gender differences in the association between oral health literacy and oral health-related quality of life in older adults. BMC Oral Health. 2022;22(1):205.
• 30) Zhou Y, Lin HC, Lo ECM, et al. Rural–urban disparities in oral health literacy and oral health status among Chinese adults. Community Dent Oral Epidemiol. 2021;49(5):411–9.
• 31) Gaikwad RN. Quantifying OHIP in the context with oral health literacy in rural and urban population. J Contemp Dent Pract. 2019;20(7):834–7.
• 32) VanWormer JJ, Tambe SR, Acharya A. Oral health literacy and outcomes in rural Wisconsin adults. J Rural Health. 2019;35(1):12–21.
• 33) Pälvärinne R, Widström E, Forsberg BC, et al. The healthcare system and the provision of oral healthcare in European Union member states. Part 9: Sweden. Br Dent J. 2018;224(8):647–51.
• 34) Henderson E, Dalawari P, Mercer A, et al. Association of oral health literacy and dental visitation in an inner-city emergency department population. Int J Environ Res Public Health. 2018;15(8):1748.
• 35) An R, Li S, Li Q, et al. Oral health behaviors and oral health-related quality of life among dental patients in China. Patient Prefer Adherence. 2022;16:3045–58
• 36) Naghibi Sistani MM, Yazdani R, Virtanen J, et al. Determinants of oral health: Does oral health literacy matter? Int Sch Res Notices. 2013;2013(1):249591.
• 37) Glick M, Williams DM, Kleinman DV, et al. A new definition for oral health. Br Dent J. 2016;221(12):792–3.
• 38) Joshi S, Suominen AL, Knuuttila M, et al. Toothbrushing behaviour and periodontal pocketing: An 11-year longitudinal study. J Clin Periodontol. 2018;45(2):196–203.
• 39) Yan W, Li M, Luo L, et al. Oral health literacy and its associated factors among nurses. J Clin Nurs. 2023;32(15-16):5056–64.