Assessment of Oral Health Literacy and Its Association with Oral Hygiene Practices among Adults: A Cross-Sectional Study

Abstract Background: Oral health literacy (OHL)—the capacity to obtain, process, and understand oral-health information—has emerged as a modifiable determinant of behaviors such as toothbrushing frequency, interdental cleaning, and dental attendance. Evidence links lower OHL with poorer oral-health behaviors and outcomes across diverse populations. Objectives: To assess OHL among adults and examine its association with oral-hygiene practices and clinical oral-hygiene status. Methods: In a cross-sectional survey of 600 adults, OHL was measured with a validated instrument and categorized as low, moderate, or high. Outcomes included toothbrushing twice daily, interdental cleaning, mouthwash use, dental visit in the past year, and Simplified Oral Hygiene Index (OHI-S). Associations were tested using χ² and multivariable logistic regression adjusted for sociodemographics. Results: High OHL was associated with higher likelihood of toothbrushing twice daily (low 28%, moderate 53%, high 79%; p<0.001) and greater use of interdental cleaning and mouthwash. In adjusted models, each 1-point increase in OHL score increased odds of brushing twice daily (OR > 1; p<0.001). Higher OHL correlated with lower OHI-S scores, indicating better clinical hygiene. Conclusions: OHL showed strong, graded associations with key oral-hygiene behaviors and clinical status. Integrating OHL-oriented counseling and plain-language materials into primary dental care and community programs may improve behaviors at scale.