Caregivers' oral health literacy and their young children's oral health-related quality-of-life

OBJECTIVES: To investigate the association of caregivers’ oral health literacy (OHL) with their children's oral health related-quality of life (C-OHRQoL) and explore literacy as a modifier in the association between children's oral health status (COHS) and C-OHRQoL. METHODS: We relied upon data from structured interviews with 203 caregivers of children ages 3-5 from the Carolina Oral Health Literacy (COHL) Project. Data were collected for OHL using REALD-30, caregiver-reported COHS using the NHANES-item, and COHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). We also measured oral health behaviors (OHBs) and socio-demographic characteristics and calculated overall/stratified summary estimates for OHL and C-OHRQoL. We computed Spearman's rho and 95% confidence limits (CL) as measures of correlation of OHL/COHS with C-OHRQoL. To determine whether OHL modified the association between COHS and C-OHRQoL, we compared literacy-specific summary and regression estimates. RESULTS: Reported COHS was: excellent—50%, very good—28%, good—14%, fair—6%, poor—2%. The aggregate C-OHRQoL mean score was 2.0 (95% CL:1.4, 2.6), and the mean OHL score 15.9 (95% CL:15.2, 16.7). There was an inverse relationship between COHS and C-OHRQoL: rho=-0.32 (95% CL:-0.45, -0.18). There was no important association between OHL and C-OHRQoL; however, deleterious OHBs were associated with worse C-OHRQoL. Literacy-specific linear and Poisson regression estimates of the association between COHS and C-OHRQoL departed from homogeneity (Wald X(2) P<0.2). CONCLUSION: In this community-based sample of caregiver/child dyads, we found a strong correlation between OHS and C-OHRQoL. The association's magnitude and gradient were less pronounced among caregivers with low literacy