|Year : 2015 | Volume
| Issue : 3 | Page : 328-330
Assessment of oral health literacy among patients attending Malabar dental college and research centre in Kerala: A cross sectional survey
Mary Shimi S Gomez1, BK Sujatha2
1 Department of Public Health Dentistry, Government Dental College, Kottayam, Kerala, India
2 Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
|Date of Web Publication||14-Sep-2015|
B K Sujatha
Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Centre, No. 82, EPIP Area, ITPL, Whitefield, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Introduction: Oral health literacy is relatively a new, but critical concept to decrease disparities and increase oral health for all. Low oral health literacy contributes to oral disease which results in increased cost for vulnerable population such as poor, those with low levels of education, minorities, and the elderly. Aim: To assess oral health literacy among patients attending Malabar dental college and research centre in Kerala. Materials and Methods: Health literacy in dentistry scale questionnaire with 29 items was administered by the investigator to collect data related to oral health literacy among 272 patients attending Malabar Dental College and Research Centre. The collected data were compiled and statistically analyzed using Chi-square test. Results: The oral health literacy was assessed based on the interquartile range, of 272 patients, 23.9% of patients had poor oral health literacy, 57% were found to have moderate oral health literacy, and 19.1% patients were found to have good oral health literacy. The results were significant at P < 0.001. Conclusion: Oral health literacy was found to be moderate among patients attending Malabar Dental College and Research Centre.
Keywords: Dental health literacy scale, oral health, oral health literacy
|How to cite this article:|
Gomez MS, Sujatha B K. Assessment of oral health literacy among patients attending Malabar dental college and research centre in Kerala: A cross sectional survey. J Indian Assoc Public Health Dent 2015;13:328-30
|How to cite this URL:|
Gomez MS, Sujatha B K. Assessment of oral health literacy among patients attending Malabar dental college and research centre in Kerala: A cross sectional survey. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jan 29];13:328-30. Available from: http://www.jiaphd.org/text.asp?2015/13/3/328/165291
| Introduction|| |
Health literacy is a set of understandings and skills that contribute to health and wellbeing. According to National Literacy Act, 1991, literacy is defined as "The ability to read, write, speak, and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one's goals and develop one's knowledge and potential." , Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. ,, Health literacy is inextricably linked to improving oral health. Oral health literacy is defined as the degree to which individuals have the capacity to obtain process and understand basic oral health information and services needed to make appropriate health decisions and act on them. ,,,,
Oral health literacy varies by race, ethnicity, level of education, and poverty level.  The lower the literacy, the more likely the individual will have poor oral health, use fewer preventive procedures and use costly services and they are less likely to manage chronic health problems. 
Oral health literacy is dependent on the culture and society, education system, healthcare, and public health systems which in turn will have an influence on oral health outcome and costs. , Individuals need to know: (a) How to locate and navigate a health facility (b) read, understand and complete many kinds of forms to receive treatment and payment reimbursement (c) and symptoms with a particular disease/condition (d) know about various types of health professionals and what services they provide and how to access those services (e) know how and when to ask questions or ask for clarification when they do not understand. 
Oral health literacy is also dependent on knowledge of consumers and providers of health topics.  Patients with limited or inaccurate knowledge about the body and causes of disease may not: (a) Understand the relationship between lifestyle factors and health outcome (b) recognize when they need to seek care (c) have current prevention information (d) providers who do not keep current with the state of the science cannot provide accurate knowledge and information and evidence-based services for their patients.  Thus, oral health literacy is one of the determinants of oral health. Since, there are only limited studies available in the literature assessing the oral health literacy among Indian population the present study has been conducted.
Aim of the study
To assess oral health literacy among patients attending Malabar dental college and research centre in Kerala.
| Materials and methods|| |
The study design is a cross-sectional survey. The study protocol was prepared, and ethical approval was obtained from the Institutional Review Board. Health literacy in dentistry with 29 items scale questionnaire was used for the present survey to collect data related to oral health literacy.  The type of questionnaire was closed-ended. The questionnaire was tested for validity and reliability before the start of the survey. Test and retest method was used to check for reliability, and the value was found to be 0.80 back translation method was used to check content validity of the questionnaire. The questionnaire had all 29 items translated in two languages: English and Malayalam.
A convenient sampling technique was used for the present survey. The survey was conducted on 272 patients attending Malabar Dental College and Research Centre in the month of July 2014. Written informed consent was obtained from the patients. The questionnaire was administered by the investigator in the waiting room of the dental college after explaining the objective of the study to the subjects. The questionnaire consisted of the demographic details and oral health literacy proper which includes items related to receptivity, understanding, support, economic barriers, access, communication, and utilization.
The collected data were compiled and analyzed using SPSS (IBM) version 16. As the data were qualitative, Chi-square test was used to find the significant difference in oral health literacy among the patients.
| Results|| |
A sample of 272 patients enrolled in the present cross-sectional survey. The median age of the patients was found to be 25 years. Based on the interquartile range, all the patients were divided according to their oral health literacy as follows, those who scored ≤22 were considered to have poor oral health literacy, patients who scored 23-27 were said to have moderate oral health literacy and study subjects who scored ≥28 were considered to have good oral health literacy.
In the present study, of 272 patients, 132 were females, and 140 were males constituting 48.5% and 51.5%, respectively, [Table 1]. In a sample of 272 patients, 23.9% of patients had poor oral health literacy, 57% were found to have moderate oral health literacy, and 19.1% patients were found to have good oral health literacy. The results were significant at P < 0.001 [Table 2].
| Discussion|| |
A cross-sectional survey was carried out among the patients attending Malabar dental college and research centre in Kerala to assess their oral health literacy. In the present study, oral health literacy was found to be moderate. Since, it is the first study of its kind where oral health literacy was assessed using health literacy in dentistry scale; no comparison has been done with other studies. The probable reason for moderate oral health literacy among patients can be attributed to their literacy level, attitude toward oral health, lack of time among dentists to communicate with the patients due to their busy schedule, prescriptions of the dentists, which most of the patients do not understand.
India is a vast South Asian country with 1.28 billion population.  The literacy rate is 74.04% according to 2011 census which was increased from 64.8% in 2001 census and Kerala holds first place in literacy.  Oral health literacy is one of the determinants of oral health. There are many reasons why these preventable oral diseases are so widespread and why people do not adopt practices that have been scientifically shown to be effective in maintaining oral health. While citing other factors such as cultural, financial; literacy or more specifically health literacy emerges as one of the major key issues.  Poor literacy can impede one's ability not only to seek out needed health information but also to process, understand and use it to make appropriate health care decisions.  Curative and preventive oral services might be less effective in patients with low literacy level because they do not understand the instructions or the importance of oral health measures. In the present study, convenient sampling technique was used by including the patients attended dental college in the month of July, demographic details and its influence on oral health literacy has not been assessed. Further studies have to be conducted by overcoming the above-mentioned limitations.
| Conclusion|| |
Oral health literacy was found to be moderate among patients attending Malabar dental college and research centre in Kerala. Since oral health is an integral part of general health, it is very important for the patients to have good oral health literacy, which help them in maintaining oral health as well as general health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Baker DW. The meaning and the measure of health literacy. J Gen Intern Med 2006;21:878-83.
Oates DJ, Paasche MK. Health literacy. Communication strategies to improve patient comprehension of cardiovascular health. Am Heart Assoc 2009;119:1049-51.
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;65:174-82.
Lee JY, Divaris K, Baker AD, Rozier RG, Vann WF Jr. The relationship of oral health literacy and self-efficacy with oral health status and dental neglect. Am J Public Health 2012;102:923-9.
ADA. Health Literacy in Dentistry Action Plan 2010-2015. National Oral Health Conference. Saint Louis, MO; April 26-28, 2010.
Jamieson LM, Divaris K, Parker EJ, Lee JY. Oral health literacy comparisons between indigenous Australians and American Indians. Community Dent Health 2013;30:52-7.
Gironda M, Der-Martirosian C, Messadi D, Holtzman J, Atchison K. A brief 20-item dental/medical health literacy screen (REALMD-20). J Public Health Dent 2013;73:50-5.
Horowitz AM. Health literacy: A link to community interventions; Children′s oral health summit. San Luis Obispo, CA; 2014.
Nutbeam D. Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21 st
century. Health Promot Int 2000;15:259-67.
Garcia RI, Cadoret CA, Henshaw M. Multicultural issues in oral health. Dent Clin North Am 2008;52:319-32, vi.
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.
Jones K, Parker E, Mills H, Brennan D, Jamieson LM. Development and psychometric validation of a health literacy in dentistry scale (HeLD). Community Dent Health 2014;31:37-43.
D′Cruz AM, Shankar Aradhya MR. Health literacy among Indian adults seeking dental care. Dent Res J (Isfahan) 2013;10:20-4.
[Table 1], [Table 2]