Comparing Parent Dental Functional Health Literacy and Child's Oral Health

Objectives: In statewide surveys children of parents incorrectly following questionnaire skip patterns had significantly worse oral health. This study determines if parental dental functional health literacy (FHL) relates to child oral health status and if skip pattern inconsistency relates to FHL and child oral health.

Methods: Consenting parents of children in the UCSF Pediatric Dental Clinic (N=101) were administered the California Smile Survey (including an ordinal oral health rating of their child) and randomly assigned one of two versions of the Oral Health-Related Quality of Life (OHRQOL) scale (Filstrup et al., 2003). FHL was tested using the Rapid Estimate of Adult Literacy in Dentistry (REALD-30) (Lee et al., 2007). Number of decayed, missing and filled primary teeth (dmft) and tooth-surfaces (dmfs) were obtained from children's attending dentists. Pearson correlation (r) and Spearman rank correlation (rs) coefficients assessed associations. Since some distributions were skewed, natural logarithm and square transformations were used. Unpaired t-tests compared REALD-30 by skip pattern and by OHRQOL version.

Results: Our sample (N=101) consists of mostly white and African-American males, with a mean age of 6.6 years, 66% have MediCal, 61% are in a free or reduced-price lunch program, and 66% report visiting the dentist in the past year. Results indicate higher parent FHL (REALD-30) was modestly negatively correlated with worse child objective oral health (dmfs: r=-0.23, dmft: r=-0.24) but not subjective oral health (OHRQOL: r=-0.04, ordinal: rs=-0.12). Subjective oral health measures were correlated with objective ones (rs(ordinal,dmfs)=0.46, rs(ordinal,dmft)=0.43, r(OHRQOL,dmfs)=0.31, and r(OHRQOL,dmft)=0.29). Mean REALD-30 was suggestive of differing by skip pattern: inconsistent=19.9 vs consistent=22.2 (p=0.087). OHRQOL did not differ by version (19.3 vs 19.9) (p=0.711).

Conclusions: Despite limitations (eg REALD-30 limited to English readers and speakers), parent FHL appears somewhat negatively related to children's oral health status. Moreover, skip pattern inconsistency appears as a potential proxy of FHL.

Support: COHORT Training Grant US/DHHS/NIH/NIDCR T32DE07306 (GW Marshall) and NIDCR & NCMHD U54DE14251.