Caregivers' oral health literacy and their young children's oral health-related quality-of-life

Acta Odontol Scand. 2012 Sep;70(5):390-7. doi: 10.3109/00016357.2011.629627. Epub 2011 Dec 8.


Objectives: To investigate the association of caregivers' oral health literacy (OHL) with their children's oral health related-quality of life (C-OHRQoL) and explore literacy as a modifier in the association between children's oral health status (COHS) and C-OHRQoL.

Methods: This study relied upon data from structured interviews with 203 caregivers of children aged 3-5 from the Carolina Oral Health Literacy (COHL) Project. Data were collected for OHL using REALD-30, caregiver-reported COHS using the NHANES-item and C-OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). This study also measured oral health behaviors (OHBs) and socio-demographic characteristics and calculated overall/stratified summary estimates for OHL and C-OHRQoL. Spearman's rho and 95% confidence intervals (CI) were computed as measures of correlation of OHL and COHS with C-OHRQoL. To determine whether OHL modified the association between COHS and C-OHRQoL, this study compared literacy-specific summary and regression estimates.

Results: Reported COHS was: excellent-50%, very good-28%, good-14%, fair-6%, poor-2%. The aggregate C-OHRQoL mean score was 2.0 (95% CI: 1.4, 2.6), and the mean OHL score 15.9 (95% CI: 15.2, 16.7). There was an inverse relationship between COHS and C-OHRQoL: ρ = -0.32 (95% CI: -0.45, -0.18). There was no important association between OHL and C-OHRQoL; however, deleterious OHBs were associated with worse C-OHRQoL. Literacy-specific linear and Poisson regression estimates of the association between COHS and C-OHRQoL departed from homogeneity (Wald χ(2) p < 0.2).

Conclusion: In this community-based sample of caregiver/child dyads, a strong correlation was found between OHS and C-OHRQoL. The association's magnitude and gradient were less pronounced among caregivers with low literacy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health*
  • Beverages
  • Black or African American
  • Bottle Feeding
  • Caregivers* / psychology
  • Child, Preschool
  • Cohort Studies
  • Dietary Sucrose / administration & dosage
  • Educational Status
  • Feeding Behavior
  • Fruit
  • Health Behavior
  • Health Literacy*
  • Health Status
  • Humans
  • Indians, North American
  • Middle Aged
  • North Carolina
  • Oral Health*
  • Quality of Life*
  • White People
  • Young Adult


  • Dietary Sucrose