Application of a Visual Oral Health Literacy Instrument in Elementary School Children

Abstract

A visual oral health literacy instrument has previously been used to assess the oral health literacy of high school students. This study applied the visual instrument to 292 elementary schoolchildren in Saitama Prefecture to assess the level of oral health literacy and investigate relationships between oral health literacy and age, gender, and oral health habits. A self-administered questionnaire survey investigated self-perceived oral health, brushing frequency, and frequency of sweet food and drink intake. Subjects drew their anterior dentition and gingivae using a hand mirror, and the drawings were scored according to set criteria. Subjects were split into three age groups: younger, middle, and older. Oral health literacy increased as age group ascended. Tooth drawings had higher scores than gingival drawings in all age groups (p < 0.001). In older schoolchildren, females had higher scores than males (p < 0.01), and more frequent tooth brushing was associated with higher scores (p < 0.05). In younger children, more frequent consumption of sweet food was related to lower gingival scores (p < 0.05). The findings suggest that this instrument is appropriate for assessing oral health literacy in elementary school children, but for gingival drawings may be best suited to children aged 10 or above, due to limited drawing ability.