The relationship between caregiver functional oral health literacy and child oral health status

Patient Educ Couns. 2014 Mar;94(3):411-6. doi: 10.1016/j.pec.2013.10.018. Epub 2013 Nov 5.


Objective: To describe the relationship between caregivers' oral health literacy (OHL) and the oral health status of their children in an Asian population.

Methods: A random sample of 301 child/caregiver dyads was recruited from kindergartens in Hong Kong. Two locally-developed and validated OHL assessment tasks were administered to caregivers with Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) assessing word recognition and Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P) assessing comprehension. Their children's oral health status was assessed [dental caries experience - decayed, missing, filled teeth index - (dmft) and oral hygiene status - Visible Plaque Index (VPI)].

Results: Caregivers' literacy was associated with children's oral health status. The HKOHLAT-P had a stronger association with children's oral health than HKREALD-30. HKOHLAT-P and HKREALD-30 remained associated with dmft in the adjusted negative binomial regression models (accounting for socio-demographics), Incidence Rate Ratio (IRR) 0.97, p=0.02, and 0.96, p=0.03, respectively. In the adjusted model, HKOHLAT-P was associated with VPI (IRR 0.90, p<0.05), but no association between HKREALD-30 and VPI was evident.

Conclusion: The main conclusion of this study was that caregiver oral health literacy was associated with their child's oral health status. A comprehension instrument had a more robust association with children's oral status than a word recognition instrument.

Practice implications: This study has implications for general public health education for designing community-level interventions.

Keywords: Caregiver; Child; Oral health literacy; Oral health status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Caregivers*
  • Child, Preschool
  • Cross-Sectional Studies
  • Dental Care for Children / statistics & numerical data*
  • Dental Caries
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Health Literacy*
  • Hong Kong
  • Humans
  • Male
  • Middle Aged
  • Oral Health*
  • Oral Hygiene
  • Parents / education
  • Socioeconomic Factors