Health literacy and oral health-related behaviors among young adults in Norway

Authors

  • Lene Marita Steinvik Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway https://orcid.org/0009-0008-8191-1610
  • Gro Eirin Holde Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway https://orcid.org/0000-0001-9849-8780
  • Hanne S. Finbråten Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, University of Inland Norway, Elverum, Norway https://orcid.org/0000-0001-8911-2102
  • Elin K. Evensen Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway https://orcid.org/0000-0002-5962-6695
  • Linda Maria Stein Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Oral Health Centre of Expertise in Rogaland, Stavanger, Norway https://orcid.org/0000-0001-5401-7463

DOI:

https://doi.org/10.2340/aos.v84.44230

Keywords:

Health literacy, preventive dentistry, public health dentistry, oral hygiene, dental health services

Abstract

Objective: The transition from adolescence to adulthood represents an increase in autonomy and responsibility of oral health-related behaviors, in which health literacy might play a significant role. The objective of the study was to assess health literacy in a young adult population and determine whether health literacy is associated with their oral health-related behaviors. 

Materials and methods: Utilizing data from the Fit Futures longitudinal cohort study, this cross-sectional analysis was based on self-administered questionnaires from the third wave, FF3. Health literacy was assessed using a short version of the European Health Literacy Survey Questionnaire (HLS-Q12), while oral health-related behaviors were assessed through toothbrushing frequency and dental service utilization. In addition, socioeconomic factors were included as control variables. Bivariate analyses and multivariable logistic regression were performed. 

Results: The findings indicated that 38% of the young adults had a score equivalent to having lower levels of health literacy. Higher health literacy scores were associated with more regular dental service use, even after adjusting for socioeconomic covariates. 

Conclusion: Although most young adults had good oral health-related behaviors, it is concerning that a significant proportion still neglects regular dental visits and consistent tooth brushing. These findings highlight the need for greater emphasis on health literacy within public dental health services.

Downloads

Download data is not yet available.

References

Buchmann MC, Kriesi I. Transition to adulthood in Europe. Ann Rev Sociol. 2011;37:481–503. https://doi.org/10.1146/annurev-soc-081309-150212 DOI: https://doi.org/10.1146/annurev-soc-081309-150212

Nordström M, Carlsson P, Ericson D, Hedenbjörk-Lager A, Jansson H, Wolf E, et al. Some young adults can maintain good oral health despite socioeconomic challenges. Eur J Oral Sci. 2024;132(3):e12985. https://doi.org/10.1111/eos.12985 DOI: https://doi.org/10.1111/eos.12985

Oral health behavior. Encyclopedia of Public Health. Wilhelm Kirch, Editor. Springer: Dordrecht, Netherlands; 2008. p. 1040. https://doi.org/10.1007/978-1-4020-5614-7_2445 DOI: https://doi.org/10.1007/978-1-4020-5614-7_2445

Broadbent JM, Zeng J, Foster Page LA, Baker SR, Ramrakha S, Thomson WM. Oral health-related beliefs, behaviors, and outcomes through the life course. J Dent Res. 2016;95(7):808–13. https://doi.org/10.1177/0022034516634663 DOI: https://doi.org/10.1177/0022034516634663

Hadler-Olsen E, Jonsson B. Oral health and use of dental services in different stages of adulthood in Norway: a cross sectional study. BMC Oral Health. 2021;21(1):257. https://doi.org/10.1186/s12903-021-01626-9 DOI: https://doi.org/10.1186/s12903-021-01626-9

Park MJ, Paul Mulye T, Adams SH, Brindis CD, Irwin CE, Jr. The health status of young adults in the United States. J Adolesc Health. 2006;39(3):305–17. https://doi.org/10.1016/j.jadohealth.2006.04.017 DOI: https://doi.org/10.1016/j.jadohealth.2006.04.017

Löe H. Oral hygiene in the prevention of caries and periodontal disease. Int Dent J. 2000;50(3):129–39. https://doi.org/10.1111/j.1875-595X.2000.tb00553.x DOI: https://doi.org/10.1111/j.1875-595X.2000.tb00553.x

Ekornrud T, Skjøstad O, Rødseth SC. Quality indicators in oral health care: a Nordic project. Proceedings in 2012–2018, an update. Helsedirektoratet: Oslo; 2019. Contract No.: 30.04.2019.

Lov om tannhelsetjenesten (LOV-1983-06-03-54). Norwegian Government: Royal Ministery of Health and Care Services; 1983 [cited 2014 Jul 04]. Available from: https://lovdata.no/dokument/NL/lov/1983-06-03-54

Steinvik LM, Svartdal F, Johnsen JK. Delay of dental care: an exploratory study of procrastination, dental attendance, and self-reported oral health. Dent J (Basel). 2023; 11(2):56. https://doi.org/10.3390/dj11020056 DOI: https://doi.org/10.3390/dj11020056

Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. https://doi.org/10.1186/1471-2458-12-80 DOI: https://doi.org/10.1186/1471-2458-12-80

Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97–107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005 DOI: https://doi.org/10.7326/0003-4819-155-2-201107190-00005

Guo Y, Logan HL, Dodd VJ, Muller KE, Marks JG, Riley JL, 3rd. Health literacy: a pathway to better oral health. Am J Public Health. 2014;104(7):e85–91. https://doi.org/10.2105/AJPH.2014.301930 DOI: https://doi.org/10.2105/AJPH.2014.301930

Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021;42:159–73. https://doi.org/10.1146/annurev-publhealth-090419-102529 DOI: https://doi.org/10.1146/annurev-publhealth-090419-102529

Buja A, Grotto G, Montecchio L, De Battisti E, Sperotto M, Bertoncello C, et al. Association between health literacy and dietary intake of sugar, fat and salt: a systematic review. Public Health Nutr. 2021;24(8):2085–97. https://doi.org/10.1017/S1368980020002311 DOI: https://doi.org/10.1017/S1368980020002311

Sukhabogi JR, Doshi D, Vadlamani M, Rahul V. Association of oral health literacy with oral health behavior and oral health outcomes among adult dental patients. Indian J Dent Res. 2020;31(6):835–9. https://doi.org/10.4103/ijdr.IJDR_337_19 DOI: https://doi.org/10.4103/ijdr.IJDR_337_19

Baskaradoss JK. The association between oral health literacy and missed dental appointments. J Am Dent Assoc. 2016;147(11):867–74. https://doi.org/10.1016/j.adaj.2016.05.011 DOI: https://doi.org/10.1016/j.adaj.2016.05.011

Silva-Junior MF, Rosário de Sousa MDL, Batista MJ. Health literacy on oral health practice and condition in an adult and elderly population. Health Promot Int. 2021;36(4):933–42. https://doi.org/10.1093/heapro/daaa135 DOI: https://doi.org/10.1093/heapro/daaa135

Baskaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health. 2018;18(1):172. https://doi.org/10.1186/s12903-018-0640-1 DOI: https://doi.org/10.1186/s12903-018-0640-1

Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67(12):2072–8. https://doi.org/10.1016/j.socscimed.2008.09.050 DOI: https://doi.org/10.1016/j.socscimed.2008.09.050

Stein L, Bergdahl M, Pettersen KS, Bergdahl J. Effects of the conceptual model of health literacy as a risk: a randomised controlled trial in a clinical dental context. Int J Environ Res Public Health. 2018;15(8):1630. https://doi.org/10.3390/ijerph15081630 DOI: https://doi.org/10.3390/ijerph15081630

Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–60. https://doi.org/10.1016/S0140-6736(19)31146-8 DOI: https://doi.org/10.1016/S0140-6736(19)31146-8

Kickbusch I, Pelikan JM, Apfel F, Tsouros AD. Health literacy: the solid facts. Regional Office for Europe: World Health Organization, Copenhagen; 2013.

Le C, Finbråten HS, Pettersen KS, Guttersrud Ø. Befolkningens helsekompetanse, del I. Helsedirektoratet: Oslo; 2021. Contract No.: 13.10.2022.

Kühn L, Bachert P, Hildebrand C, Kunkel J, Reitermayer J, Wäsche H, et al. Health literacy among university students: a systematic review of cross-sectional studies. Front Public Health. 2021;9:680999. https://doi.org/10.3389/fpubh.2021.680999 DOI: https://doi.org/10.3389/fpubh.2021.680999

Winther A, Dennison E, Ahmed LA, Furberg AS, Grimnes G, Jorde R, et al. The Tromsø Study: fit futures: a study of Norwegian adolescents’ lifestyle and bone health. Arch Osteoporos. 2014;9:185. https://doi.org/10.1007/s11657-014-0185-0 DOI: https://doi.org/10.1007/s11657-014-0185-0

Finbråten HS, Wilde-Larsson B, Nordström G, Pettersen KS, Trollvik A, Guttersrud Ø. Establishing the HLS-Q12 short version of the European Health Literacy Survey Questionnaire: latent trait analyses applying Rasch modelling and confirmatory factor analysis. BMC Health Serv Res. 2018;18(1):506. https://doi.org/10.1186/s12913-018-3275-7 DOI: https://doi.org/10.1186/s12913-018-3275-7

Sorensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13:948. https://doi.org/10.1186/1471-2458-13-948 DOI: https://doi.org/10.1186/1471-2458-13-948

Guttersrud Ø, Le C, Pettersen KS, Helseth S, Finbråten HS. Towards a progression of health literacy skills: establishing the HLS-Q12 cutoff scores. Research Square: Durham, NC; 2019. DOI: https://doi.org/10.21203/rs.2.13456/v2

Firmino RT, Martins CC, Faria LDS, Martins Paiva S, Granville-Garcia AF, Fraiz FC, et al. Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis. J Public Health Dent. 2018;78(3):231–45. https://doi.org/10.1111/jphd.12266 DOI: https://doi.org/10.1111/jphd.12266

Ericsson JS, Wennström JL, Lindgren B, Petzold M, Östberg AL, Abrahamsson KH. Health investment behaviours and oral/gingival health condition, a cross-sectional study among Swedish 19-year olds. Acta Odontol Scand. 2016;74(4):265–71. https://doi.org/10.3109/00016357.2015.1112424 DOI: https://doi.org/10.3109/00016357.2015.1112424

Strategi for å øke helsekompetansen i befolkningen. Norwegian Gov-ernment: Royal Ministery of Health and Care services; 2019 [cited 2024 Jul 04]. Available from: https://www.regjeringen.no/no/dokumenter/strategi-for-a-oke-helsekompetansen-i-befolkningen-2019-2023/id2644707/

Jones K, Parker E, Mills H, Brennan D, Jamieson LM. Development and psychometric validation of a Health Literacy in Dentistry scale (HeLD). Community Dent Health. 2014;31(1):37–43. https://doi.org/10.1111/cdoe.12133 DOI: https://doi.org/10.1111/cdoe.12133

Lee JY, Rozier RG, Lee SY, Bender D, Ruiz RE. Development of a word recognition instrument to test health literacy in dentistry: the REALD-30 – a brief communication. J Public Health Dent. 2007;67(2):94–8. https://doi.org/10.1111/j.1752-7325.2007.00021.x DOI: https://doi.org/10.1111/j.1752-7325.2007.00021.x

Published

2025-08-14