Validation of the Brazilian Oral Health Literacy-Adults Questionnaire.

BACKGROUND: Recognizing that a deficit of reading and numeracy skills is associated with poorer oral health, contemporary researchers have identified additional components as important attributes of oral health literacy (OHL). So, the use of comprehensive functional OHL tools is crucial. The Oral Health Literacy-Adults Questionnaire (OHL-AQ) evaluates reading comprehension, numeracy, listening and decision-making skills. OBJECTIVE: Describe the validation process of the OHL-AQ Brazilian version (BOHL-AQ). METHODS: The cross-culturally adapted version, BOHL-AQ, was applied to 180 employees age 18 to 71 years (mean = 37.2; standard deviation [SD] = 11.7) from a private university located in the Southeast of Brazil. Psychometric properties were evaluated through the analysis of internal consistency (Cronbach's alpha), reproducibility (test-retest), convergent validity (BREALD-30; education level), discriminant validity (family income; dental services), predictive validity (self-perception; literacy questions) and construct validity (Exploratory Factor Analysis). Confirmatory Factor Analysis (CFA) evaluated the dimensionality of the BOHL-AQ, with Promax method for rotation. Data were analyzed using SPSS Statistics software and the Mplus program. KEY RESULTS: BOHL-AQ mean score = 11.84 (SD = 3.1); administration mean time = 8 minutes (SD = 1.6); good internal reliability (Cronbach's alpha = 0.73) and excellent reproducibility (kappa = 0.89; intraclass correlation coefficient = 0.97). Preliminary tests showed that data were suitable for PCA (Kayser-Meyer-Olkin measure = 0.75; Barlett's Test of Sphericity significant [p < .001]). CFA showed that the instrument had a four-factor solution with excellent model fit estimates (χ2 = 636.587154.16, p value = .00117, Comparative Fit Index = 0.9787, Tucker Lewis index = 0.97, and Root Mean Square Error of the Approximation = 0.03). BOHL-AQ high scores significantly correlated to high education level, dental visit within the last year and for preventive reason, more independence and self-confidence on reading and filling out health forms, and better oral health self-perception (p < .05). CONCLUSIONS: The BOHL-AQ showed to be a fast and reliable instrument to assess a comprehensive functional OHL at Brazilian community and clinical settings. [HLRP: Health Literacy Research and Practice. 2022;6(3):e224-e231.] Plain Language Summary: Recognizing the need of advancing knowledge related to OHL, this study aimed to describe the validation process of the BOHL-AQ. Cross-cultural adaptation and psychometric properties evaluation presented satisfactory results. The BOHL-AQ proved to be a fast and valid instrument to measure comprehensive functional OHL in the Brazilian context.

Oral health status and associated lifestyle behaviors in a sample of Iranian adults: an exploratory household survey.

BACKGROUND: Poor oral hygiene can lead to serious diseases, such as periodontitis, tooth decay, pain and discomfort in teeth or gums, infections, and loss of teeth. In Iran, adults aged 50 y and older are a high-risk group for oral health problems, and this age group will grow in the coming decades. Despite increasing attention on healthy aging, there is relatively less emphasis on oral hygiene and health-related problems. The present study investigated the oral health status of Iranian adults using the oral health self-assessment questionnaire (OHQ) developed by the World Health Organization (WHO). METHODS: A population-based household survey of a sample of adults aged 18-65 y was conducted. In this study, the participants were recruited between May and October 2016 in Tabriz, Iran, and the study population was sampled using a multi-stage cluster sampling design. The WHO's OHQ for adults was used for measuring oral health status and oral hygiene behavior. RESULTS: In total, 2310 respondents completed the survey. The mean age (SD) of the participants was 41.6(23.4) y. Males accounted for 48.8% of the participants. Of the 2310 respondents,187 (8.1%) individuals were edentulous, 152(20.7%) of whom were aged 51-65 y. Furthermore, 72.3% of those aged 51-65 y were dentate, and 50% of adults aged 51-65 y said they had 20 or more teeth. About one-third of the participants reported that they did not brush their teeth daily (23% of those aged 18-35 y,35.9% of those aged 36-50 y, and 44.6% for those aged 51-65 y). In the sample, 39.4% of individuals aged 18-35 y,34.1% of individuals aged 36-50 y, and 26.6% of individuals aged 51-65 y had visited a dentist less than 6 month ago. One-third of the participants consumed sweets and sugary drinks daily. CONCLUSIONS: Although the majority of Iranian adults considered their oral health status good, only a small percentage of the sample visited their dentist regularly. Furthermore, visits to the dentist declined in accordance with increasing age, a time when the incidence of oral health problems may increase. Poor oral health may increase the risk of adverse health outcomes, particularly among the aging population.

New Internship Course at Health Centers for Dental Undergraduates of Babol University of Medical Sciences in 2014: Students' Perception.

OBJECTIVES: This study aimed to evaluate an innovative internship course at health centers for final-year dental undergraduates and to report initial students' perceptions. MATERIALS AND METHODS: The Department of Community Oral Health, Faculty of Dentistry with the collaboration of the Vice-Chancellor of Health of Babol University of Medical Sciences prepared an educational and clinical training course, named Health Centers Dental Rotation (HCDR), in January 2014. Final year (6th year) dental undergraduates were divided into groups of two or three and worked as an operator or assistant at 12 health centers (six rural and six urban). Students had to fulfill the educational and therapeutic requirements for three weeks. Students' perspectives related to the course objectives were recorded using a five-point Likert scale with a voluntary anonymous questionnaire. RESULTS: Forty-four dental students, 26 (60%) females and 18 (40%) males, provided oral health care services at the health centers. Based on the students' perspectives, almost all students (95%) realized the limitations of the health centers. The HCDR improved the awareness of 75% of the students about oral health needs and problems of patients referring to these centers. Although 68% of the students declared that participating in this course was a valuable educational experience, 38.6% described it as displeasing. CONCLUSION: From the students' perspectives, this course was a worthwhile and positive internship experience and provided an opportunity for students to understand the specific oral health needs of patients attending these health centers and to realize their key role in the oral health system.

Nine years' trend of dental caries and severe early childhood caries among 3-6-year-old children in Babol, Northern Iran.

BACKGROUND AND OBJECTIVE: Malnutrition, pain, and insomnia are common adverse effects of early dental caries among 3-6-year-old children. To increase our understanding of the dental caries status which will help in the control and prevention of it, this study aimed to assess the trend of dental caries, Severe Early Childhood Caries (S-ECC) and its related factors among 3-6-year-old children during a 9-year period in Babol, Northern Iran. METHODS: This was a cross-sectional study among 2,080 children aged 3-6 years old in Babol, Northern Iran. The studied samples were examined from May 2007 to June 2015. Oral examinations were performed with visual-touch technique. S-ECC was measured as number of decayed, missing, and filled teeth surface (dmfs). Data were evaluated by SPSS software for Windows version 23 and were analyzed using the one-way ANOVA, chi-square test and independent-samples t-test. Level of significance was set at ≤ 0.05. RESULTS: The trend of dental caries and S-ECC rose among 3-6-year-old children over a 9-year period. Of the children, 26.3% were caries free. The mean dmft was increased significantly among boys (p<0.001), among 3-4-year-old children (p=0.01), and those children with both employed parents (p=0.01) and low educated parents (p<0.001) from 2007 to 2015. CONCLUSION: Dental caries status showed an increasing trend over the study period in Babol preschool children, therefore effective preventive strategies are required to decrease the prevalence of dental caries in children.

Association of oral health behavior and the use of dental services with oral health literacy among adults in Tehran, Iran.

OBJECTIVE: To assess the association of oral health behavior (OHB) and the use of dental services with oral health literacy (OHL) among Iranian adults. METHODS: This was a cross-sectional population study of a random sample of 1031 adults aged 18-65 in Tehran, Iran. We collected data on tooth brushing frequency, the consumption of sugary snacks and beverages, and time since last dental visit. To measure OHL, we used a validated OHL adults' questionnaire (OHL-AQ). In addition to descriptive analysis, we used multiple logistic regression models to assess the association of OHB and the most recent dental visit with OHL while controlling for socioeconomic and demographic factors. RESULTS: The participants' mean age was 36.3 (standard deviation 12.9), and 51% were women. Of the participants, 81.3% reported brushing their teeth daily (≥1/day), 37.6% consumed sugary snacks or beverages between meals less than once daily (<1/day), and 36.8% used dental services within the past 6 months. In the adjusted models, high OHL scores significantly correlated with daily (≥1/day) tooth brushing (odds ratio [OR] = 1.97, 95% confidence interval [CI]: 1.30-2.98), the consumption of sugary snacks or beverages (<1/day between meals) (OR = 1.56, 95% CI: 1.13-2.15) and the recent use of dental services (≤6 months) (OR = 1.59, 95% CI: 1.15-2.21), respectively. CONCLUSIONS: OHL relates significantly to improved OHB and the use of dental services. Oral health promotion programs should, therefore, take into account improvements in adults' OHL, particularly in countries with developing health-care services.

Parents' Oral Health Literacy and its Impact on their Children's Dental Health Status.

INTRODUCTION: Because parents play a key role in children's dental health, the aim of this study was to determine the relationship between parents' oral health literacy (OHL) and their children's dental health status in Babol, Iran. METHODS: In this cross sectional study a total of 384 children aged 21 months to 84 months who attended the dental clinic of Babol University of Medical Sciences between September 2015 and February 2016 were examined. We measured dmft index only for primary dentition; during examination the accompanying parent completed the "Oral Health Literacy-Adults Questionnaire". Comparing mean analysis, such as one-way analysis of variance (ANOVA), and an independent-samples t-test, served to compare children's dental caries, missing, and dental fillings' mean differences, between subgroups. In addition, the relationship between OHL, children's dental caries, and dental fillings was assessed using multiple linear regression models while controlling for socioeconomic and demographic factors. All data were analyzed by SPSS version 22. RESULTS: Children's mean age was 55.1 months (SD: 13.7), while 47% were girls. Mean children's dental caries, missing, filling, and mean dmft index were 6.5, 0.4, 1.2, and 8.2 respectively. Parents with inadequate OHL had children with more dental caries (p=0.005), however this relation had no significance while controlling for background factors. Increasing children's dental fillings was significantly related with families living in urban regions (p=0.01, 95% CI: 0.11 to 1.12), and parents with adequate OHL (p=0.02, 95% CI: 0.08 to 1.05). CONCLUSION: Inadequate parents' OHL was associated with children having high dental caries and less dental fillings. Therefore, providing interventions to improve parents' OHL would be valuable in children's dental health promotion programs, especially in countries with a developing oral health system.