The impact of oral health literacy and family cohesion on dental caries in early adolescence

Objectives The aim of this study was to evaluate the association between the prevalence of cavitated dental caries and oral health literacy (OHL), family characteristics and sociodemographic factors in early adolescence. Methods A cross-sectional study was conducted with 740 twelve-year-old students. The students' guardians provided information on sociodemographic data, and the students provided information on family characteristics and OHL. Two trained dentists examined the participants for dental caries and administered the Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry (BREALD-30). Control variables were selected using a directed acyclic graph. Descriptive analysis was performed; this was followed by robust Poisson regression analysis for complex samples to evaluate the association between dental caries and socioeconomic and family predictors (alpha = 5%). Results The following variables were associated with a greater number of cavitated caries lesions: low level of education completed by the mother (RR = 1.58; 95% CI: 1.12-2.24), less privileged social class (RR = 1.89; 95% CI: 1.28-2.80), non-White ethnicity (RR = 1.64; 95% CI: 1.0-2.48), larger number of residents in the home (RR = 1.87; 95% CI: 1.25-2.81), low level of OHL (RR = 2.02; 95% CI: 1.28-3.18), and the 'connected' (RR = 4.72; 95% CI: 1.17-18.90), 'separated' (RR = 4.09; 95% CI: 1.05-15.86) and 'disengaged' (RR = 4.20; 95% CI: 1.09-16.18) types of family cohesion. Conclusions A low level of oral health literacy, sociodemographic factors, and a low level of family cohesion are predictors of cavitated caries lesions in early adolescence.