Oral Health Literacy and Dental Care-Seeking Behavior Among Adults: A Cross-Sectional Study

Authors

  • Aliya Ameen Asian Institute of Medical Sciences, AIMS Karachi, Pakistan Author https://orcid.org/0009-0009-8296-0278
  • Shanza Akram Asian Institute of Medical Sciences, AIMS Karachi, Pakistan Author
  • Maham Riaz Asian Institute of Medical Sciences, AIMS Karachi, Pakistani Author

DOI:

https://doi.org/10.68041/johdt.v1i1/03

Keywords:

Cross-Sectional Studies, Dental Care, Health Literacy, Health Services Accessibility, Oral Health

Abstract

Background: Oral health literacy can impact preventive dental attendance and early care-seeking. This study aimed to determine the relationship between oral health literacy and dental care-seeking behaviors in adults. Methods: 130 adults' data from July to December 2023 was analyzed. A 12-item questionnaire was scored from 0–12, with 0 indicating a low level, 12 a high level, and intermediate scores a moderate level. Statistical analyses included descriptive statistics, chi-square tests, the Mann–Whitney U test, and binary logistic regression. The regression was only conducted in participants who reported having an oral-health problem (N = 92) and adjusted for age, sex, education, literacy score, and household income. Results: Participants' mean age was 38.6 ± 11.1 years; 65(50.0%) had a moderate literacy level, and 98(75.4%) had a previous appointment with a dentist. 56(43.1%) reported regular/preventive attendance and 42(32.3%) reported symptom driven attendance. The attendance pattern was correlated with literacy category (χ²=25.22, p<0.001). Among participants reporting oral-health issues, 36(39.1%) delayed care, with differences by literacy category (χ² = 6.38, p = 0.041). However, continuous literacy scores (p = 0.116) and adjusted regression (aOR = 0.858, 95% CI: 0.688–1.072; p = 0.177) showed no significant association with delayed care. Conclusion: There was a general correspondence of attendance with categorical literacy levels; however, no clear correspondence was identified for adjusted associations. Validated measures and larger samples could be used in future studies to evaluate literacy in relation to access barriers.

Author Biographies

  • Aliya Ameen, Asian Institute of Medical Sciences, AIMS Karachi, Pakistan

    Department of Pathology

  • Shanza Akram, Asian Institute of Medical Sciences, AIMS Karachi, Pakistan

    Department of Pathology

  • Maham Riaz, Asian Institute of Medical Sciences, AIMS Karachi, Pakistani

    Department of Pathology

References

1. Yu S, Huang S, Song S, Lin J, Liu F. Impact of oral health literacy on oral health behaviors and outcomes among the older adults: a scoping review. BMC Geriatr. 2024;24(1). https://doi.org/10.1186/s12877-024-05469-1 DOI: https://doi.org/10.1186/s12877-024-05469-1

2. Lu X, Nanjappa S, Wijesiri TID, Mossey P, Yuan S. The role of health literacy in adults' dental service utilisation: a scoping review. Community Dent Oral Epidemiol. 2026;54(2):133–145. https://doi.org/10.1111/cdoe.70037 DOI: https://doi.org/10.1111/cdoe.70037

3. Juneja A, Batra P, Sultan A, Katyal S. Relationship between oral health literacy (OHL) and dental anxiety in parents of children with dental caries visiting tertiary health care centre. Cumhuriyet Dent J. 2025;28(1):108–114. https://doi.org/10.7126/cumudj.1614208 DOI: https://doi.org/10.7126/cumudj.1614208

4. Yan W, Li M, Luo L, Ju X, Jamieson L, Liu F. Oral health literacy and its associated factors among nurses: a cross-sectional study. J Clin Nurs. 2023;32(15–16):5056–5064. https://doi.org/10.1111/jocn.16750 DOI: https://doi.org/10.1111/jocn.16750

5. Aliyu TK, Titus OS, Bernard OT, Alade OT, Ehizele AO, Foláyan MO. Cultural themes related to oral health practices, beliefs, and experiences in Nigeria: a scoping review. Oral. 2025;5(2):23. https://doi.org/10.3390/oral5020023 DOI: https://doi.org/10.3390/oral5020023

6. Sukhabogi JR, Doshi D, Vaggala B, Billa AL. Development and validation of dental visiting behavior among adults based on health belief model. J Oral Biol Craniofac Res. 2024;14(5):620–625. https://doi.org/10.1016/j.jobcr.2024.08.004 DOI: https://doi.org/10.1016/j.jobcr.2024.08.004

7. Hajek A, Kretzler B, König HH. Factors associated with dental service use based on the Andersen model: a systematic review. Int J Environ Res Public Health. 2021;18(5):2491. https://doi.org/10.3390/ijerph18052491 DOI: https://doi.org/10.3390/ijerph18052491

8. Krishnan L, Aarthy CS, Kumar PDM. Barriers to access dental care services among adult population: a systematic review. J Glob Oral Health. 2020;3(1):54–62. https://doi.org/10.25259/JGOH_1_2020 DOI: https://doi.org/10.25259/JGOH_1_2020

9. Obeidat R, Heaton LJ, Tranby EP, O'Malley J, Timothé P. Social determinants of health linked with oral health in a representative sample of U.S. adults. BMC Oral Health. 2024;24(1):1518. https://doi.org/10.1186/s12903-024-05257-8 DOI: https://doi.org/10.1186/s12903-024-05257-8

10. Currie CC, Araujo-Soares V, Stone SJ, Beyer F, Durham J. Promoting regular dental attendance in problem-orientated dental attenders: a systematic review of potential interventions. J Oral Rehabil. 2021;48(10):1183–1191. https://doi.org/10.1111/joor.13244 DOI: https://doi.org/10.1111/joor.13244

11. Dean AG, Sullivan KM, Soe MM. OpenEpi: a web-based epidemiologic and statistical calculator for public health. Public Health Rep. 2009;124(3):471–474. https://doi.org/10.1177/003335490912400320 DOI: https://doi.org/10.1177/003335490912400320

12. Badran A, Keraa K, Farghaly MM. The impact of oral health literacy on dental anxiety and utilization of oral health services among dental patients: a cross-sectional study. BMC Oral Health. 2023;23(1):146. https://doi.org/10.1186/s12903-023-02840-3 DOI: https://doi.org/10.1186/s12903-023-02840-3

13. Moore S, Baca O, Ahrens C. Learning technologies for adult literacy: a scoping review and analysis of the current state of evidence. Educ Technol Res Dev. 2023;71(6):2195–2219. https://doi.org/10.1007/s11423-023-10270-9 DOI: https://doi.org/10.1007/s11423-023-10270-9

14. Nguyen DP, McQuistan MR, Qian F, Hernández M, Macek MD, Chi DL. The interactive effects of oral health literacy and acculturation on dental care use among Hispanic adults. J Public Health Dent. 2022;82(3):295–302. https://doi.org/10.1111/jphd.12529 DOI: https://doi.org/10.1111/jphd.12529

15. An R, Chen WF, Li S, Wu Z, Liu M, Sohaib M. Assessment of the oral health literacy and oral health behaviors among nurses in China: a cross-sectional study. BMC Oral Health. 2022;22(1):602. https://doi.org/10.1186/s12903-022-02658-5 DOI: https://doi.org/10.1186/s12903-022-02658-5

16. Cui Z, Wang W, Si Y, Wang X, Feng X, Tai B, et al. Tooth brushing with fluoridated toothpaste and associated factors among Chinese adolescents: a nationwide cross-sectional study. BMC Oral Health. 2023;23(1). https://doi.org/10.1186/s12903-023-03506-w DOI: https://doi.org/10.1186/s12903-023-03506-w

17. Chakraborty-Groot T, Almansa J, de Winter AF, Linares-Jimenez FG, Schuller AA, Reijneveld SA. Patterns of multimorbidity and their association with edentulism: the moderating role of health literacy in the Lifelines Cohort. Eur J Public Health. 2026;36(4):ckag099. https://doi.org/10.1093/eurpub/ckag099 DOI: https://doi.org/10.1093/eurpub/ckag099

18. Yang L, Guo D, Zheng J, Guo Y, Li Z. Association between social participation and remaining teeth and urban–rural difference among older adults in China. Int J Environ Res Public Health. 2023;20(2):1283. https://doi.org/10.3390/ijerph20021283 DOI: https://doi.org/10.3390/ijerph20021283

19. Joshi BM, Khatiwada SP, Pokhrel RK. Influence of socioeconomic factors on access to digital resources for education. Rupantaran A Multidiscip J. 2024;8(1):17–33. https://doi.org/10.3126/rupantaran.v8i01.65197 DOI: https://doi.org/10.3126/rupantaran.v8i01.65197

20. Shrivastava PK, Mehta A, Deka BP, Mathur MR. Barriers and facilitators in utilisation of dental health services across low- and middle-income countries: a scoping review. Evid Based Dent. 2026;27(1):19. https://doi.org/10.1038/s41432-025-01200-0 DOI: https://doi.org/10.1038/s41432-025-01200-0

21. Evans MV, Andréambeloson T, Randriamihaja M, Ihantamalala F, Cordier L, Cowley G, et al. Geographic barriers to care persist at the community healthcare level: evidence from rural Madagascar. PLOS Glob Public Health. 2022;2(12):e0001028. https://doi.org/10.1371/journal.pgph.0001028 DOI: https://doi.org/10.1371/journal.pgph.0001028

22. Čabraja LK, Dukić W, Barišić ML. Prevalence of dental anxiety and the influence of various factors in children aged 12 to 18 years in Zagreb, Croatia. Children. 2026;13(10):1384. https://doi.org/10.3390/children13101384 DOI: https://doi.org/10.3390/children13101384

Downloads

Published

2026-10-30

Issue

Vol. 1 No. 1 (2026): October

Section

Original Article

License

Copyright (c) 2026 Aliya Ameen, Shanza Akram, Maham Riaz (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Journal of Oral Health and Dental Therapeutics (JOHDT) follows the Attribution Creative Commons-Non commercial (CC BY-NC 4.0) license which allows the users to copy and redistribute the material in any medium or format, remix, transform and build upon the material. The users must give credit to the source and indicate, provide a link to the license, and indicate if changes were made. However, the CC BY-NC 4.0 license restricts the use of material for commercial purposes (Further details are available at website. The Editorial Board of the JOHDT endeavors to ensure the accuracy, integrity, and quality of all published content. However, the responsibility of opinions, interpretations, and conclusions expressed in the published articles rests entirely with the authors and do not necessarily reflect the views of the Editorial Board, publisher, or affiliated institutions.

How to Cite

Oral Health Literacy and Dental Care-Seeking Behavior Among Adults: A Cross-Sectional Study. (2026). Journal of Oral Health and Dental Therapeutics, 1(1), 10-14. https://doi.org/10.68041/johdt.v1i1/03