The association between oral health literacy and missed dental appointments

J Am Dent Assoc. 2016 Nov;147(11):867-874. doi: 10.1016/j.adaj.2016.05.011. Epub 2016 Aug 3.


Background: In this study, the author identified associations among demographic characteristics, dental risk factors, health-seeking behaviors, oral health literacy level, and failure to keep dental appointments.

Methods: The author conducted an unmatched 1:2 case-control study at a university-based dental clinic from February through April 2015. The author used the Comprehensive Measure of Oral Health Knowledge questionnaire to record the oral health literacy of the respondents. The author obtained additional information about the various covariates using a questionnaire and checking the patients' electronic medical records. The author used a multivariate logistic regression analysis to test the associations between missed appointments and other risk factors in addition to oral health literacy.

Results: Data from 150 (50 case patients and 100 control patients) respondents were included in the analysis. The case and control patients were comparable in terms of sociodemographic characteristics and dental risk factors. The Comprehensive Measure of Oral Health Knowledge score was used to categorize the sample into low (≤ 18) and high (> 18) oral health literacy groups. Low oral health literacy was associated with a 2-fold increase in the risk of having missed appointments (adjusted odds ratio, 2.38; 95% confidence interval, 1.05-5.40). Age was also independently associated with missed appointments (adjusted odds ratio, 1.03; 95% confidence interval, 1.01-1.06).

Conclusions: After adjusting for the various demographic and dental risk factors, poor oral health literacy was found to be independently associated with missed dental appointments. Insights into the role of oral health literacy and clinic attendance could play an important role in addressing the problem of missed dental appointments.

Practical implications: Considering the effects of missed appointments on treatment outcomes, predictors of patient compliance behaviors may be useful in circumventing cancellations and no shows.

Keywords: Health knowledge; attitudes; health literacy; oral health; patient appointments; practice.

MeSH terms

  • Appointments and Schedules*
  • Case-Control Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Literacy*
  • Humans
  • Male
  • Middle Aged
  • Ohio
  • Oral Health*
  • Patient Acceptance of Health Care*
  • Risk Factors
  • Surveys and Questionnaires