Assessing the relationship between caregivers' pediatric oral health literacy and children's caries status

Abstract

Purpose: The primary aims of this study were to 1) determine if caregivers' oral health literacy is associated with children's caries status using two different oral health literacy instruments, 2) explore if caregivers' scores on these instruments are correlated, and 3) compare caregivers' reading recognition and vocabulary knowledge. Methods:This was a cross-sectional study of primary caregivers and their 3-to-6 year old children conducted at a combined university-hospital dental clinic. Consenting caregivers completed an 18-item demographic and dental utilization survey, the Rapid Estimate of Adult Literacy in Dentistry (REALD-30), the Oral Health Literacy Inventory for Parents (OH-LIP) Parts I and II. The REALD-30 and OH-LIP I and II interviews were audio-recorded for scoring and reliability testing. All dmft scores were determined during the course of a full dental examination completed by a pediatric dental resident or faculty member. Results: Fifty-seven caregiver-patient pairs participated in this study. There were strong statistically significant correlations between the REALD-30, OH-LIP I, and OH-LIP II scores (r>0.7, p<0.001). Neither the OH-LIP I, OH-LIP II, or REALD-30 scores were significantly associated with dmft scores in unadjusted or adjusted Poisson regression models. REALD-30 and the OH-LIP I scores were generally high, indicating most caregivers were able to recognize and pronounce dental terms. OH-LIP II scores revealed wide variation in caregivers' ability to define pediatric dental terms, even though most could pronounce the terms correctly. Conclusions: These results indicate that the REALD-30 and the OH-LIP II may have wider internal and external validity than the OH-LIP I, given their strong correlation and association with numerous demographic/dental characteristics known to be associated with low oral health literacy. The OH-LIP II offers a deeper understanding of caregivers' oral health literacy than word recognition instruments, as demonstrated by caregivers who frequently had an incorrect or incomplete understanding of common dental terms, despite their ability to pronounce them correctly. Additional research is needed to explore the possible association between caregiver oral health literacy, caries in children, and factors which may influence this relationship. Since caregivers are primarily responsible for the oral health practices of young children, their oral health literacy levels can affect their children's oral health and caries experience. Pediatric dentists should be aware of oral health literacy levels and appropriately tailor oral health messages.