Relationship between Oral Health Literacy and Dental Anxiety

Objectives: Oral health literacy (OHL) and dental anxiety are important determinants of oral health. However, the relationship between the two factors is not very well understood. The purpose of this study was to investigate any association between OHL and dental anxiety among adults.
Methods: The study sample was 290 volunteer adult patients attending a university dental clinic. Data were collected by a self-administered questionnaire that was developed from previously validated instruments and included items about socio-demographic attributes, OHL, and dental anxiety levels. Total OHL and anxiety scores were computed by summing the respective questionnaire items related to each domain, and the resultant scores were dichotomized at the median levels; study sample was divided into two age groups with the cutoff of 60 years. Chi-squared tests of association and binary logistic regression analyses investigated any association between OHL and dental anxiety.
Results: The mean age of the sample was 54.6±18.3 with 50.7% males and 55.9% whites. While 49.3% of the study subjects had low levels of oral health literacy, 10.7% had high levels of dental anxiety. The mean OHL and anxiety scores were: 6.3±1.8 (scale of zero to 10) and the anxiety score was 7.7±3.0 (scale of 4 to 16). Bivariate analyses showed that low OHL was significantly associated with younger age group (OR=2.3, 95% CI=1.4-3.6), white ethnicity (OR=0.43, 95% CI=0.3-0.7), and low education levels (OR=2.2, 95% CI=1.4-3.6); high dental anxiety was associated with being female (OR=2.8, 95% CI=1.3-6.4) and non-white (OR=2.5, 95% CI=1.2-5.5). Multivariate logistic regression models confirmed the aforementioned associations controlling for relevant covariates.
Conclusions: No significant association was found between dental anxiety and oral health literacy. Future research should focus on assessing the relationship between OHL and dental anxiety in a more representative study sample including additional covariates such as household income.