Impact of Caregiver Literacy on Children's Oral Health Outcomes

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Abstract
OBJECTIVE: The objective of this study was to examine the relationship of primary caregivers9 literacy with children9s oral health outcomes. METHODS: We performed a cross-sectional study of children who were aged ≤6 years and presented for an initial dental appointment in the teaching clinics at the University of North Carolina at Chapel Hill School of Dentistry. Caregiver literacy was measured using the Rapid Estimate of Adult Literacy in Dentistry (REALD-30). The outcome measures included oral health knowledge, oral health behaviors, primary caregiver9s reports of their child9s oral health status, and the clinical oral health status of the child as determined by a clinical examination completed by trained, calibrated examiners. RESULTS: Among the 106 caregiver–child dyads enrolled, 59% of the children were male, 52% were white, and 86% of caregivers were the biological mothers. The bivariate results showed no significant relationships between literacy and oral health knowledge (P = .16) and behaviors (P = .24); however, there was an association between literacy and oral health status (P < .05). The multivariate analysis controlled for race and income; this analysis revealed a significant relationship between caregiver literacy scores and clinical oral health status as determined by using a standardized clinical examination. Caregivers of children with mild to moderate treatment needs were more likely to have higher REALD-30 scores than those with severe treatment needs (odds ratio: 1.14 [95% confidence interval: 1.05–1.25]; P = .003). CONCLUSIONS: Caregiver literacy is significantly associated with children9s dental disease status.