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Ju, Lee, and Oh: Relationship of oral health literacy with oral health behaviors among adults
Original Article

J Korean Acad Oral Health 2015;39(3):186-194.

Published online: 12 September 2015

DOI: https://doi.org/10.11149/jkaoh.2015.39.3.186

Relationship of oral health literacy with oral health behaviors among adults

Hyun-Jeong Ju, Heung-Soo Lee, Hyo-Won Oh

Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, Iksan, Korea

Corresponding Author: Heung-Soo Lee Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Korea Tel: +82-63-850-6851 Fax: +82-63-850-6851 E-mail: smagn@wonkwang.ac.kr

Received 13 August 2015       Revised 15 September 2015       Accepted 17 September 2015

Copyright © 2015 Journal of Korean Academy of Oral Health

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to investigate the relationship between oral health literacy and oral health behaviors.

Methods

The study subjects were 760 adults who were selected using the convenience sampling method. The participants were administered a self-report questionnaire. Oral health literacy was classified into two categories: verbal oral health literacy and functional oral health literacy. The oral heath behaviors that were surveyed included perceived oral health status, perceived oral health interest, perceived oral health knowledge, experience of visiting dental clinic, experience of scaling, and the frequency of toothbrushing. Sociodemographic characteristics such as age, gender, marital status, educational level, and family income were also surveyed.

Results

The ratio of self-perceived good oral health status and toothbrushing more than three times a day was higher in the participants with high oral health literacy than in those with low oral health literacy. Oral health literacy was positively correlated with oral health behaviors. Perceived oral health status, perceived oral health interest, perceived oral health knowledge, experience of scaling, and frequency of daily toothbrushing were also positively correlated with oral health literacy. Furthermore, perceived oral health status and frequency of daily toothbrushing were both correlated with verbal oral health literacy and functional oral health literacy. A multiple logistic regression analysis demonstrated that oral health literacy was correlated with oral health behaviors. Verbal oral health literacy was correlated with perceived oral health interest, perceived oral health knowledge, and frequency of daily toothbrushing. Functional oral health literacy was correlated with perceived oral health status.

Conclusions

To improve the oral health of adults, oral health literacy, which is related to oral health behaviors, should be considered alongside the implementation of appropriate oral health education. Furthermore, an oral health literacy intervention should be immediately developed.

Keywords: Adult, Behaviors, Literacy, Oral health, Toothbrushing

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Table 1.
Perceived oral health status according to level of oral health literacy (N, %)
Oral health literacy Poor Fair Good Total P-value
Verbal Lower 25% 69 (34.0) 89 (43.8) 45 (22.2) 203 (100.0) 0.015
Upper 25% 47 (24.5) 79 (41.1) 66 (54.0) 192 (100.0)
Total 116 (29.4) 168 (42.5) 111 (28.1) 395 (100.0)
Functional Lower 25% 95 (34.5) 122 (44.4) 58 (21.1) 275 (100.0) 0.003
Upper 25% 80 (25.7) 128 (41.2) 103 (33.1) 311 (100.0)
Total 175 (29.9) 250 (42.7) 161 (27.5) 586 (100.0)

The data were analysed by chi-square test.

Table 2.
Perceived oral health interest according to level of oral health literacy (N, %
Oral health literacy Low High Total P-value
Verbal Lower 25% 113 (55.7) 90 (44.3) 203 (100.0) <0.001
Upper 25% 60 (31.3) 132 (68.8) 192 (100.0)
Total 173 (43.8) 222 (56.2) 395 (100.0)
Functional Lower 25% 115 (41.8) 160 (58.2) 275 (100.0) 0.586
Upper 25% 137 (44.1) 174 (55.9) 311 (100.0)
Total 252 (43.0) 334 (57.0) 586 (100.0)

The data were analysed by chi-square test.

Table 3.
Perceived oral health knowledge according to level of oral health literacy (N, %)
Oral health literacy Low High Total P-value
Verbal Lower 25% 165 (81.3) 38 (18.7) 203 (100.0) <0.001
Upper 25% 86 (44.8) 106 (55.2) 192 (100.0)
Total 251 (63.5) 144 (36.5) 395 (100.0)
Functional Lower 25% 187 (68.0) 88 (32.0) 275 (100.0) 0.237
Upper 25% 197 (63.3) 114 (36.7) 311 (100.0)
Total 384 (65.5) 202 (34.5) 586 (100.0)

The data were analysed by chi-square test.

Table 4.
Experience of scaling according to level of oral health literacy (N, %
Oral health literacy Yes No Total P-value
Verbal Lower 25% 143 (70.4) 60 (29.6) 203 (100.0) 0.008
Upper 25% 157 (81.8) 35 (18.2) 192 (100.0)
Total 300 (75.9) 95 (24.1) 395 (100.0)
Functional Lower 25% 216 (78.5) 59 (21.5) 275 (100.0) 0.945
Upper 25% 245 (78.8) 66 (21.2) 311 (100.0)
Total 461 (78.7) 125 (21.3) 586 (100.0)

The data were analysed by chi-square test.

Table 5.
Frequency of daily toothbrushing according to level of oral health literacy (N, %)
Oral health literacy ≤2 3 ≥4 Total P-value
Verbal Lower 25% 84 (41.4) 101 (49.8) 18 (8.9) 203 (100.0) <0.001
Upper 25% 41 (21.4) 116 (60.4) 35 (18.2) 192 (100.0)
Total 125 (31.6) 217 (54.9) 53 (13.4) 395 (100.0)
Functional Lower 25% 106 (38.7) 133 (48.5) 35 (12.8) 274 (100.0) 0.003
Upper 25% 80 (25.7) 188 (60.5) 43 (13.8) 311 (100.0)
Total 186 (31.8) 321 (54.9) 78 (13.3) 585 (100.0)

The data were analysed by chi-square test.

Table 6.
Correlations between oral health literacy and oral health behaviors
Oral health literacy Perceived oral health status Perceived oral health interest Perceived oral health knowledge Experience of visiting dental clinic Experience of scaling Frequency of daily tooth- brushing
Verbal 0.100** 0.189** 0.282** 0.040 0.103** 0.152**
Functional 0.111** −0.005 0.039 0.024 −0.002 0.110**

**P<0.01 (Pearson correlation coefficient).

Table 7.
Multiple logistic regression analysis about factors related perceived oral health status
Variables Model 1 Model 2 Model 3
Exp (B) P-value Exp (B) P-value Exp (B) P-value
Age 0.881 0.265 0.919 0.468 0.916 0.452
Gender (male) 1.296 0.206 1.255 0.267 1.288 0.220
Family income 1.070 0.458 1.059 0.532 1.058 0.593
Education level (college) 1.168 0.327 1.215 0.207 1.153 0.372
Marital status (married) 0.937 0.805 0.818 0.932 0.941 0.843
Verbal oral health literacy 1.023 0.060 1.017 0.178
Functional oral health literacy 1.131 0.015 1.113 0.038
Table 8.
Multiple logistic regression analysis about factors related perceived oral health interest & perceived oral health knowledge
Variables Perceived oral health interest Perceived oral health knowledge
Exp (B) P-value Exp (B) P-value
Age 1.026 0.004 1.026 0.007
Gender (male) 0.992 0.962 1.093 0.596
Family income 1.041 0.567 1.001 0.989
Education level (college) 1.813 <0.001 1.446 0.042
Marital status (married) 0.752 0.212 0.667 0.096
Verbal oral health literacy 1.044 <0.001 1.080 <0.001
Functional oral health literacy 0.946 0.138 1.004 0.914
Table 9.
Multiple logistic regression analysis about factors related frequency of daily toothbrushing & experience of scaling
Variables Experience of scaling Frequency of daily toothbrushing
Exp (B) P-value Exp (B) P-value
Age 1.032 0.005 0.958 <0.001
Gender (male) 0.702 0.072 0.709 0.049
Family income 1.069 0.432 0.914 0.243
Education level (college) 1.520 0.037 2.142 <0.001
Marital status (married) 1.372 0.256 1.627 0.061
Verbal oral health literacy 1.028 0.010 1.027 0.006
Functional oral health literacy 1.029 0.522 1.043 0.278
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