Mothers' oral health literacy and children's oral health status in Pikine, Senegal: A pilot study

Health and oral health literacy: A comprehensive literature review from theory to practice

BACKGROUND

Health literacy (HL) refers to an individual's ability to access, understand, and apply health information to make informed decisions about their health. On the contrary, oral health literacy (OHL) focuses on an individual's ability to understand and utilize oral health information to maintain good oral health.

AIM

This study presents a comprehensive literature review that explores the theoretical foundations and practical applications of HL and OHL.

DESIGN

A comprehensive search was conducted using keywords on the following databases: PubMed, Google Scholar, and Cochrane Database of Systematic Reviews.

RESULTS

The existing literature on various aspects of HL, including the most common used definitions of HL, conceptual frameworks, and consequences of limited health and OHL, was summarized. Additionally, the review discussed the significance of HL and OHL. Also, the relation between parent level of OHL and children's oral health was described. It further highlights modern approaches that have been shown in previous studies to improve the OHL of primary caregivers.

CONCLUSIONS

Understanding the significance of HL and OHL is crucial in developing effective interventions that can address disparities and improve oral health outcomes for individuals of all backgrounds.

The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study

BACKGROUND

Identifying the risk indicators of parental dental anxiety (PDA) and oral health literacy (OHL) can help oral healthcare professionals recognise challenges in this field. Armed with the appropriate information, they can effectively engage with parents to build trust and promote early and regular child dental visits.

OBJECTIVES

This study aimed to investigate the association between PDA and OHL with the sociobehavioural characteristics of families, self-reported child oral health (presence of ≥ 1 untreated decayed teeth) and the dental visit patterns amongst children living in Al Jouf Province, Kingdom of Saudi Arabia.

SUBJECTS AND METHODS

A total of 430 parents with children aged ≥ 14 years were invited using a systematic random sampling method. PDA was assessed using the Dental Anxiety Scale-Revised (DAS-R) scale, and parents' OHL was measured using the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30). The relationships amongst participant characteristics, PDA and OHL were evaluated through the Chi-square and ANOVA. Additionally, binary regression analysis was conducted to identify predictor variables associated with PDA and OHL. A P value of < 0.05 was considered statistically significant.

RESULTS

Children with ≥ 1 untreated decayed tooth were 2.5 times more likely to have PDA (95% confidence interval [CI] = 1.37, 4.37). Children who visited the dentist in < 6 months had 93% lower likelihood to have PDA (adjusted odds ratio (AOR) = 0.07; 95% CI = 0.03, 0.18). Parents aged 20-25 years were 81% less likely to have OHL than those above 30 years (AOR = 0.19; P = 0.038). Similarly, parents with medium family income were 52% less likely to have OHL than the high-income group (AOR = 0.48; P = 0.013). Finally, parents of children who visited the dentist within < 6 months were 34 times more likely to have OHL than those whose children visited the dentist > 12 months ago (AOR = 34.94; P < 0.001).

CONCLUSION

PDA and OHL were significantly affected by parental age, family income, the presence of ≥ 1 untreated decaying tooth and the child dental visit patterns. During a child's first dental visit, paediatric dentists should always assess the PDA, OHL and sociobehavioural characteristics of a family by using appropriate scales and semistructured interviews.

The association between oral health literacy and oral health-related behaviours among female adolescents in the Kingdom of Saudi Arabia: A cross-sectional study

Objectives

Oral health literacy (OHL) is suggested as an important denominator of oral health. This study aimed to identify ways to improve oral health by exploring the association between oral health literacy and oral health-related behaviours among female adolescents in the Eastern Province of the Kingdom of Saudi Arabia (KSA).

Methods

This cross-sectional study assessed OHL among 1,889 10th grade female students in the Eastern Province of the KSA. OHL was assessed using an Arabic version of the short version of the Health Literacy in Dentistry scale (A-HeLD-14). Self-reported socio-demographic information and oral health-related behaviours (toothbrushing, dental attendance, and sugary diet consumption) were also collected. The relationship between OHL and oral health-related behaviours was investigated using binary logistic regression, adjusted for socio-demographic information.

Results

The binary logistic regression analyses showed that poor OHL was significantly associated with infrequent toothbrushing (p < 0.001) and irregular dental attendance (p = 0.005) but not with consumption of sugary diets. All A-HeLD-14 domains were significantly associated with infrequent toothbrushing, and the domains concerning access, receptivity, and financial barriers were significantly associated with irregular dental attendance. The highest odds ratios (ORs) for infrequent toothbrushing were found in the domains of receptivity (OR = 4.19) and understanding (OR = 3.85) and for irregular dental attendance in the financial barriers (OR = 1.61) and access (OR = 1.49) domains, followed by the receptivity domain (OR = 1.35).

Conclusion

Poor OHL was significantly associated with infrequent toothbrushing and irregular dental attendance. Interventions focusing on OHL are warranted to improve oral health-related behaviours and thereby oral health in the population. The aspects that seem most vital to target are improved access to dental care, including the reduction of economic barriers, as well as increased awareness of oral health in the population.

Determination of the relationship between parents' health literacy and fever management of their children: A cross-sectional study

AIMS

The research was conducted to determine the practices of parents regarding the fever management of their children and reveal the relationship between their health literacy (HL) and fever management of their children.

DESIGN

Cross-sectional study was used.

METHODS

This study was carried out with 242 parents. The data were collected using the Parent Descriptive Information Form, Turkish HL Scale-32 and Parents' Fever Management Scale between September 2021 and September 2022. The data were evaluated with the SPSS program, using percentages, averages, Pearson's correlation and regression analysis.

RESULTS

The mean age of the parents was 31.87 ± 6.59. The parents' mean Parents' Fever Management Scale score was 36.22. It means that parents had high fever management practice. Their mean Turkish HL Scale-32 total score was 34.43. 51.6% of the parents had a problematic or insufficient HL level. In the cases of fever, 61.2% of the parents stated that they took off the child's clothes, 69.0% measured temperature from the armpit, and 55.4% gave antipyretics according to the doctor's prescription. There is a statistically significant positive correlation between the Parents' Fever Management Scale and Turkish HL Scale-32. It is observed that 8.2% of the change in parents' fever management is explained by HL.

CONCLUSION

The study found that with an increase in parents' HL, fever management of their children also increased.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Emerging evidence showed that developing parents' HL knowledge and skills could be an option/approach in fever management. It should be a basic nursing skill that to provide HL support to parents.

REPORTING METHOD

This study adhered to the relevant cross-sectional STROBE (the Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Impact of research paradigms on low-income female caregivers and their children: an oral health literacy discourse

Objective

Despite the vast knowledge gained through research and public health surveillance, dental caries prevalence among children from low-income households remains high. The aim of this literature review is to identify assumptions made within existing empirical, constructivist, and critical paradigms to determine how those assumptions impact knowledge and if these impacts have aided in perpetuating inequity or health disparities within this target population.

Method

A literature search of EBSCOhost, PubMed, and Web of Science was conducted to retrieve articles from peer-reviewed journals published in the last 10 years, including qualitative, quantitative, and mixed methods studies. Qualitative methods included narrative research via interviews; quantitative designs included cross-sectional studies using surveys and various indices to assess oral health literacy (OHL) levels and oral health status. Exclusion criteria were non-English studies and studies that did not include female caregivers.

Results

Nine primary research articles were selected for analysis. The positivist paradigm was dominant in 7 of 9 articles. Oral health social processes, such as the lack of value placed on oral health as a component of overall health by the broader medical community and the public, were not discussed as influencing factors on OHL.

Discussion

Assumptions identified within the dominant paradigms were determined to perpetuate inequity or health disparities, confirming a link between caregivers' OHL levels and the oral health status of their children. It is critical that all health care professionals improve their understanding of factors affecting caregivers' OHL.

Conclusion

Strategies that empower and advocate for women to improve their OHL should be developed.

Validation of an Arabic version of the short form of the health literacy in dentistry scale: a cross-sectional study

BACKGROUND

The Arabic version of the short form of the Health Literacy in Dentistry scale (HeLD) had not yet been developed in previously published studies. This study aims to test the reliability and validity of an Arabic version of the short form of the HeLD questionnaire.

METHODS

The short version of HeLD was translated into Arabic and the psychometric properties were evaluated in a sample of 1,889 female students in their first year of secondary school. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC), and internal consistency reliability was assessed using Cronbach's alpha. Content validity was investigated by creating a correlation matrix between the individual items of the HeLD-14, and criterion validity was determined using Pearson's correlation between the HeLD-14 score and an overall oral health rating. Sensitivity analysis was assessed by testing the associations of the HeLD-14 score with oral health-related behaviours and residential area.

RESULTS

The Arabic version of HeLD-14 (A-HeLD-14) had acceptable ICC (0.54) and excellent internal consistency (Cronbach's alpha: 0.92). The correlations between the items of the A-HeLD-14 varied from 0.3 to 0.9. The A-HeLD-14 showed a statistically significant correlation with the overall oral health rating (r = 0.37, p < 0.001). The median A-HeLD-14 score was significantly higher in participants who brushed their teeth frequently (51.31), visited the dentist regularly (52.00), consumed fresh fruit frequently (51) and consumed soda or energy drinks infrequently (51.00) than participants who brushed their teeth infrequently (41.50), visited the dentist irregularly (49.00), consumed fresh fruit infrequently (47) and consumed soda or energy drinks frequently (48.00).

CONCLUSION

The A-HeLD-14 instrument demonstrates sufficient validity, reliability, and sensitivity for measuring oral health literacy among the Arabic-speaking population.

Predictors of oral health literacy in pregnant women

We determined factors associate with oral health literacy of pregnant women. A total of 203 pregnant women attending Hospital Universiti Sains Malaysia (USM) for antenatal care participated in this cross-sectional study. The Malay version of Oral Health Literacy Instrument (OHLI-M) and a structured self-administered questionnaire were used to obtain variables of interest. The mean OHLI-M score was 73.6 (SD 12.59). Only slightly more than half of our participants had adequate oral health literacy (54.2%), while others were marginal (31.0%) and inadequate (14.8%). Our findings revealed that women with adequate oral health literacy were more likely to be those with higher education qualification and were very satisfied or satisfied with their oral health status. The identification of these predictors highlighted the importance to keep oral health education messages simple and clear for the benefit of individuals with low educational attainment.

Oral Health Attitude with the Socioeconomic Conditions of Mothers with Growth Stunting Children

OBJECTIVE

 This study analyzes the relationship between socioeconomic conditions and the attitude of mothers in maintaining the dental health of stunting children.

MATERIALS AND METHODS

 The research method uses correlational test with Spearman rank. The sampling technique used purposive sampling based on the inclusion criteria of mothers who had stunted children in Lengkong District, Bandung City.

RESULT

 Data analysis by the Spearman Rank resulted p-value of 0.019 (p < 0.05) which leads to a positive relationship between socioeconomic conditions an mother's attitude in maintaining the dental health of stunting children.

CONCLUSION

 From the results of the study, it can be concluded that there is a relationship between socioeconomic conditions and the attitude of mothers in maintaining the dental health of stunting children in Lengkong District, Bandung City.

The Knowledge, Attitude, and Practice of Lebanese Mothers Toward Their Children's Oral Health: A Cross-Sectional Survey

OBJECTIVES

This study aims to assess the knowledge, attitude, and practice of Lebanese mothers toward their children's oral health, examine the association between the three variables, and identify their predictors.

METHODS

A cross-sectional online survey was administered to Lebanese mothers residing in Lebanon with children aged six months to 12 years between April and May 2022. The survey was administered to mothers from various geographical areas who presented to academic medical centers, private clinics, and dispensaries. The survey gathered sociodemographic data as well as assessed the knowledge, attitude, and practice of the participating mothers toward their children's oral health.

RESULTS

A total of 357 responses were included in the final analysis. The mean age of mothers was 32.67 years +/- 6.35. The majority of mothers had one or two children (35.8% and 37.5%, respectively). More than two-thirds of the mothers were unemployed. Only 13% of the mothers followed best practices for their children's dental health, while 48.6.2% possessed above-average knowledge and 88.9% had great attitudes. Mothers with a university education had higher knowledge, better attitudes, and practice scores than those with school-level education (elementary, high school). Employed mothers had a significantly better knowledge score (p=0.036) and practice score (p=0.043) than unemployed mothers. The decrease in the number of children was associated with an increase in the maternal knowledge score. An increase in the mother's age was associated with a higher knowledge score.

CONCLUSION

The findings of this study suggest the need for targeted oral health education programs for Lebanese mothers to enhance their attitudes and practices toward their children's oral health. It highlights the importance of early oral health interventions and emphasizes the significant role of mothers in promoting good oral health practices for their children. Further research is needed on a larger scale to comprehensively understand these variables and inform the development of appropriate national oral health programs for children in Lebanon.

Rural-urban disparities in knowledge, attitude, and practice toward child oral health among mothers of 9-36-month-old children

Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health. Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed. Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother's' age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups. Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.

Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran

INTRODUCTION

The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran.

METHODS

This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05).

RESULTS

The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4).

CONCLUSION

It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.

Relationship between parents' health literacy and child health: systematic review

Purpose

Parents' health literacy is an important element to ensure the sound health of children. One of the major purposes of this study was to systematically collect and review the literature that identified the relationship between two variables: parents' health literacy and their child's health.

Design/methodology/approach

To meet the purpose, the authors searched four well-reputed research databases such as Web of Science, Scopus, Google Scholar and LISTA (Library, Information Science and Technology Abstracts) comprehensively to collect the relevant research on the topic. Except for books, various types of content from different years were used for this review. The investigators used Preferred Items for Systematic Reviews and Meta-analysis guidelines to select eligible studies for this review. The authors also assessed the quality of the reviewed research in the light of well-reputed quality guidelines shared by Boynton and Greenhalgh (2004).

Findings

The majority of the reviewed studies found a statistically significant relationship between parents' health literacy and the health of their children. Findings also identified that the majority of the reviewed literature scored from 9 to 12 on the quality assessment criteria. Results also highlighted that the majority of the reviewed research on parents' health literacy and child health has been conducted in the USA and utilized quantitative methods to conduct research on the topic under this study.

Research limitations/implications

This systematic review has multiple theoretical and practical implications for parents, policymakers and researchers.

Originality/value

This is the first systematically collected and reviewed paper on the relationship between parents' health literacy and child health.

Combined education course on nutrition, hand-washing and dental care in primary schools in Yaoundé, Cameroon

Background

Poor nutritional habits and related hygiene and sanitation practices impair food and nutrition security, and increase the risk of foodborne diseases and related school absenteeism. While the WASH program promoted by the UNICEF boosts water, sanitation, and hygiene, only a few studies thus far encouraged healthy eating habits and safe and nutritious meals at school. This study aimed at combining education of schoolchildren on nutrition and hygiene (nutrition knowledge, attitudes, practices; food choices; nutrient sources; dental care; handwashing), and at boosting the engagement of parents and teachers in the promotion of nutrition-related behaviors conducive to health and well-being.

Methods

Four primary schools in different Yaoundé Urban Councils and 71 schoolchildren aged 7-12 years enrolled in the study. In this paper we report on the i) administrative and ethical clearance, ii) sensitisation and demonstration activities, iii) donation of WASH equipment, disposable materials for hand and teeth hygiene, toolkit policy, and guidebook, iv) baseline assessment by structured questionnaire, v) combined course (1 hour/week, 6 weeks), and vi) measured impact. Scores were analysed using paired z- and t-tests with SPSS 23.0 for windows.

Results

In the four schools, handwashing showed the best improvement. Older children benefited more from the whole course, while the improvement in younger children focused more on practices. The school that scored lowest at baseline obtained marked general improvement. Interestingly, general improvement in food choices coupled with persistent difficulty in recognising nutrient sources. Although sociocultural and socioeconomic parameters were not included in the questionnaire, these emerged as possible modifiers. Despite limited hours of direct training and limited resources invested, this short-term intervention significantly changed habits of children and the school community. Availability of hand and teeth hygiene materials facilitated and motivated the proactivity of the school community to boost good nutrition and hygiene practices sustainably.

Conclusions

Preventive medicine is a balance of awareness and affordability. Having this in mind, more coordinated efforts (WASH, food safety, food security) will enforce proper nutrition and hygiene of children at school in the different Cameroonian sociocultural and socioeconomic settings.

Development and Validation of an Oral Health Literacy Measurement for Primary School Children in Thailand

Background

Oral health promotion programs have been implemented in primary schools for many years in Thailand. Oral health literacy has been introduced as a health promotion outcome; however, no assessment tool has been developed for this age group. The objective of this study was to develop and validate the Test of Functional Health Literacy in Dentistry for Primary School Children (P-TOFHLiD). Materials and Methods. The P-TOFHLiD was developed by modifying contents and outlines using a previously validated tool for older adults, then verified by two experts for face validity. A cross-sectional study was conducted with samples collected from 118 grade-six students from two government schools in Chiang Mai Province, Thailand. The P-TOFHLiD and a previously validated word recognition test were administered, followed by oral examination to assess reliability, concurrent validity, convergent validity, and predictive validity and establish the cut-off score of the tool. The statistical analysis was performed using SPSS version 25.

Results

The internal reliability of P-TOFHLiD was good (α = 0.808). The correlation coefficient between the P-TOFHLiD and grade point average was 0.478 (p value <0.001), which is the represented concurrent validity of the tool. Coefficients between P-TOFHLiD and a word recognition test was 0.422 (p-value <0.001) for convergent validity. P-TOFHLiD was significantly correlated with the number of missing teeth from tooth decay (p-value <0.05), but the correlation coefficient was poor (r = −0.100). The cut-off scores for adequate oral health literacy were set at ≥21 out of the total scores of 26.

Conclusion

P-TOFHLiD presented good validity and reliability and was ready to use for oral health promotion program evaluation. However, the predictive validity of the P-TOFHLiD in predicting oral health status was questionable only.

Do network centrality measures predict dental outcomes of Indigenous children over time?

BACKGROUND

Centrality measures identify items that are central to a network, which may inform potential targets for oral interventions.

AIM

We tested whether centrality measures in a cross-sectional network of mothers' baseline factors are able to predict the association with children's dental outcomes at age 5 years.

DESIGN

A network approach was applied to longitudinal data from a randomised controlled trial of dental caries prevention delivered to 448 women pregnant with an Indigenous child in South Australia. Central items were identified at baseline using three centrality measures (strength, betweenness, and closeness). Centrality values of mothers' outcomes were regressed with their predictive values to dental caries experience and dental service utilisation at child age 5 years.

RESULTS

Items of oral health self-efficacy and oral health literacy were central to mothers' baseline network. Strength at baseline explained 51% and 45% of items' predictive values to dental caries experience and dental service utilisation at child age 5 years, respectively. Adjusted and unadjusted values of node strength for the children's oral health network were highly correlated.

CONCLUSION

Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5 years.

Assessment of Parents' Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children

(1) Purpose: To assess the oral health literacy (OHL) of parents and its association with the caries experience of their preschool children attending the Hospital University Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia. (2) Materials and Methods: This is a descriptive cross-sectional study involving a systematic random sampling method, using a sample of 230 parent/preschool child dyads. Among 230 parents, 24 were males and 206 were females (mean age 31.43 ± 5.82); among 230 children, 92 were boys and 138 were girls (mean age 4.82 ± 1.04) attending the pedodontics clinic, HUSM, who participated and met the inclusion criteria. A structured, self-administered oral health literacy questionnaire including sociodemographic factors was used in this study. A child's oral examination was performed to check the dmft (decayed, missing, filled teeth) status. Statistical analysis was done using descriptive and Spearman's correlation analysis and multivariate regression analysis. (3) Results: The mean dmft score of children in relation to the OHL level of parents showed a significant difference (p < 0.00). The mean dmft score of children in relation to the OHL level of parents showed the following relationships: Inadequate (7.49 ± 4.10) followed by marginal (3.28 ± 2.67) and then adequate (0.55 ± 1.55). The incidence of caries amongst children in relation to parental employment was more associated with unemployed parents (6.11 ± 4.43) than with employed parents (2.79 ± 3.65). The caries experience amongst children in relation to education of their parents revealed a significant difference (p < 0.001), and the mean dmft score was high amongst preschool children with primary school qualified parents (10.7 ± 4.10) followed by high school (7.04 ± 3.68), vocational (5.81 ± 3.57), diploma (2.61 ± 2.81), and university (1.29 ± 2.27), respectively. The results revealed a valid significant difference (negative correlation, rs = -0.753 **) between the OHL of parents with the dmft score of their preschool children. The age and gender of parents was not significantly associated with OHL, whereas ethnicity (positive correlation, rs = 0.283 **), education (positive correlation, rs = 0.865 **), and employment (negative correlation, rs = -0.490 **) were found to be significant. Conclusion: We conclude that there is a significant association between the OHL of parents with the dmft score of their preschool children. The logistic regression showed that after adjustment for sociodemographic factors, parents' gender (OR = 0.067, 95% CI: 0.012-0.360), parents' employment status (OR = 3.247, 95% CI: 0.897-11.754), parents' OHL score (OR = 0.042, 95% CI: 0.016-0.114), and child age (OR = 2.195, 95% CI: 1.249-3.857) were significantly associated with dental caries in children. Our study concluded that parents' employment status, age, gender, OHL, and child's age were significantly associated with the caries experience of their preschool children.

The utility of network analysis in the context of Indigenous Australian oral health literacy

BACKGROUND

The study of oral health literacy (OHL) is likely to gain new and interesting insights with the use of network analysis, a powerful analytical tool that allows the investigation of complex systems of relationships. Our aim was to investigate the relationships between oral health literacy and oral health-related factors in a sample of Indigenous Australian adults using a network analysis approach.

METHODS

Data from 400 Indigenous Australian adults was used to estimate four regularised partial correlation networks. Initially, a network with the 14 items of the Health Literacy in Dentistry scale (HeLD-14) was estimated. In a second step, psychosocial, sociodemographic and oral health-related factors were included in the network. Finally, two networks were estimated for participants with high and low oral health literacy. Participants were categorised into 'high' or 'low' OHL networks based on a median split. Centrality measures, clustering coefficients, network stability, and edge accuracy were evaluated. A permutation-based test was used to test differences between networks.

RESULTS

Solid connections among HeLD-14 items followed the structure of theoretical domains across all networks. Oral health-related self-efficacy, sporting activities, and self-rated oral health status were the strongest positively associated nodes with items of the HeLD-14 scale. HeLD-14 items were the four most central nodes in both HeLD-14 + covariates network and high OHL network, but not in the low OHL network. Differences between high and low OHL models were observed in terms of overall network structure, edge weight, and clustering coefficient.

CONCLUSION

Network models captured the dynamic relationships between oral health literacy and psychosocial, sociodemographic and oral health-related factors. Discussion on the implications of these findings for informing the development of targeted interventions to improve oral health literacy is presented.