Oral health literacy and associated oral conditions: A systematic review.

BACKGROUND: The authors systematically reviewed the scientific evidence regarding an association between oral health literacy (OHL) and oral conditions. TYPES OF STUDIES REVIEWED: The authors performed an electronic search of 8 databases up through October 2016, as well as a manual search. The authors included studies in which the investigators evaluated oral conditions and measured OHL through a validated tool and studies in which OHL was an explanatory variable. The authors assessed risk of bias by using the Newcastle-Ottawa Scale.
RESULTS: The authors included 10 cross-sectional studies. Risk of bias was high in most studies (n = 6). Dental caries and periodontal status were the most common oral conditions reported (each outcome was reported in 5 studies). Investigators in 4 studies found a statistically significant association between dental caries and lower levels of OHL (P < .05), with investigators in 3 of the studies finding this in primary teeth. A reduced number of teeth and loss of attachment were associated with lower levels of OHL (P < .05). Findings for deep periodontal pockets, bleeding on probing, severity of periodontal disease, history of extractions, dental treatment need, and dental plaque were inconclusive. Investigators barely reported other clinical conditions such as temporomandibular joint problems, oral mucosal lesions, enamel opacities, dental fluorosis, and use of and need for dental prostheses. CONCLUSIONS AND PRACTICAL IMPLICATIONS: There seems to be a weak association between lower levels of OHL and dental caries in primary teeth. Similar findings for adults and between OHL and other oral conditions remain unsubstantiated because the results are controversial, with considerable clinical and statistical heterogeneity between studies.