Knowledge of oral health issues among low-income Baltimore adults: a pilot study.

PURPOSE: This pilot study documents conceptual knowledge of oral health among low-income adults in Baltimore. METHODS: Selected questions from the Baltimore Health Literacy and Oral Health Knowledge Project, a cross-sectional, population-based investigation of oral health literacy, were used for this analysis. Participants were asked questions during face-to-face interviews about basic oral health and the prevention and management of dental caries and periodontal diseases. Descriptive analyses included tests of association with selected socio-demographic variables (age, sex, education level, annual household income). RESULTS: The majority of respondents were African American women, 45 to 64 years of age, with 12 years of education and an income less than or equal to $25,000. Ninety-one percent of respondents knew that sugar caused dental caries, while 82% understood that the best way to prevent tooth decay was to brush and floss every day. Knowledge of oral hygiene practices and the prevention and management of gingivitis and periodontitis was mixed. Seventy-six percent understood that the best way to remove tartar was by a dental cleaning. However, only 15% knew how often to floss their teeth and only 21% knew that plaque was composed of germs. CONCLUSION: Conceptual oral health knowledge is one component of oral health literacy. In turn, oral health literacy impacts communication. Practitioners should account for limited conceptual knowledge when they discuss oral health issues with their low-income and minority patients. If this is not accounted for, they will probably find that their oral hygiene education messages are being ignored and health promotion is being adversely affected.

Measuring conceptual health knowledge in the context of oral health literacy: preliminary results.

OBJECTIVES: Health literacy encompasses several abilities including word recognition, reading comprehension, communication skills, and conceptual knowledge. To date, conceptual knowledge has not been included in oral health literacy research. This study assesses the validity and reliability of a new instrument and describes conceptual oral health knowledge among a sample of low-income adults. METHODS: One hundred Baltimore adults were administered the Rapid Estimate of Adult Literacy in Medicine (REALM), Short Test of Functional Health Literacy in Adults (Short-TOFHLA), and a new survey of conceptual oral health knowledge. Respondents were also asked about sociodemographics, dental health, and utilization. RESULTS: Psychometric analysis was used to identify a subset of oral health knowledge questions from the new survey instrument. The resulting Comprehensive Measure of Oral Health Knowledge (CMOHK) was categorized into three levels of knowledge (poor, fair, good). Nearly one-third of Baltimore adults exhibited the lowest level. CMOHK scores were significantly associated with age, education level, and word recognition (REALM). CMOHK scores were not associated with reading comprehension (Short-TOFHLA) or dental care visits. Instrument reliability was good (Cronbach alpha = 0.74). CONCLUSIONS: This preliminary study yielded a new measure of oral health conceptual knowledge, available for use in future oral health literacy studies. The author presents a conceptual framework of oral health literacy that separates health literacy into four unique components and places decision-making at the center. Future studies are needed to determine whether this framework is supported by empirical data and leads to improvements in oral health and reductions in health disparities.

Adult patient visits to physicians for dental problems.

BACKGROUND AND OBJECTIVES: Most physicians lack substantive training in dentistry and are usually not capable of providing definitive dental care. Therefore, physician offices are generally not the most appropriate site for the management of most dental problems. This study was conducted to examine the rate with which patients visit physician offices for the treatment of dental problems and their satisfaction with the treatment received. METHODS: Data on dental related problems were collected through a random telephone survey of English-speaking Maryland residents over the age of 20. A random digit dial methodology was used to generate the sampling frame. A total of 811 interviews were conducted. The overall survey has a margin of error of +/- 3.44% at the 95% confidence level. RESULTS: 5.6% of respondents reported seeing a physician for a dental problem during the prior year. Almost 80% reported being satisfied with the treatment received, while 36.4% reported needing follow-up care with a dentist for treatment of the same problem. Respondents expressing greater satisfaction with their visit to the physician were less likely to report needing to see a dentist for follow-up care (p < .05). CONCLUSIONS: Additional studies are needed to assess the quality and appropriateness of physician management of dental problems.