Periodontal disease is inflammation of the gums and without good oral hygiene, it can progress to periodontitis. Oral hygiene might be related to a patient's health literacy (HL), defined as ability to gain access, understand, and use information to promote and maintain good health. The aim of our study is to examine the associations of HL with indicators of periodontal disease. A cross-sectional study on 1117 adults (36.2% males; mean age = 36.4, SD = 14.2) attending dental hygiene treatment was conducted. Data on demographics, socioeconomic status, and nine domains of HL (Health Literacy Questionnaire, HLQ) were collected by questionnaire, and Community Periodontal Index of Treatment Needs (CPITN) was established by the dental hygienist. Data were analysed using t-tests and logistic regression. Respondents with periodontal disease (N = 152) had statistically significantly lower levels of HL in seven out of nine HLQ domains compared to intact patients (N = 818) (t from 3.03 to 4.75, p < 0.01). Association of higher HL in seven domains with lower chance of diagnosed periodontal disease remain significant even after adjustment for age, gender and educational attainment (adjusted ORs 0.55-0.67, p < 0.05). Our findings confirm that an individual's lower HL is significantly associated with higher chance of periodontal disease incidence, specifically among Slovak adults attending oral hygiene clinics. HL might be a promising factor in the improvement of oral health in this population, worthy of consideration in intervention and preventive activities.

1st Department of Stomatology Faculty of Medicine P J Šafarik University 04011 Košice Slovakia

Department of Dental Hygiene Faculty of Health Care University of Prešov 08001 Prešov Slovakia

Department of Health Psychology and Research Methodology Faculty of Medicine P J Šafárik University 04011 Košice Slovakia

Department of Stomatology and Maxilofacial Surgery Faculty of Medicine Comenius University 81250 Bratislava Slovakia

Olomouc University Social Health Institute OUSHI Palacký University 77111 Olomouc Czech Republic

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Kim J., Amar S. Periodontal Disease and Systemic Conditions: A Bidirectional Relationship. Odontology. 2006;94:10–21. doi: 10.1007/s10266-006-0060-6. PubMed DOI PMC

Michaud D.S., Fu Z., Shi J., Chung M. Periodontal Disease, Tooth Loss, and Cancer Risk. Epidemiol. Rev. 2017;39:49–58. doi: 10.1093/epirev/mxx006. PubMed DOI PMC

World Health Organization Health Promotion Glossary. Health Promot. Int. 1998;4:349–364.

Krishnan K., Chen T., Paster B.J. A Practical Guide to the Oral Microbiome and its Relation to Health and Disease. Oral Dis. 2017;23:276–286. doi: 10.1111/odi.12509. PubMed DOI PMC

Kononen E., Gursoy M., Gursoy U.K. Periodontitis: A Multifaceted Disease of Tooth-Supporting Tissues. J. Clin. Med. 2019;8:1135. doi: 10.3390/jcm8081135. PubMed DOI PMC

Shi M., Wei Y., Hu W., Nie Y., Wu X., Lu R. The Subgingival Microbiome of Periodontal Pockets with Different Probing Depths in Chronic and Aggressive Periodontitis: A Pilot Study. Front. Cell. Infect. Microbiol. 2018;8:124. doi: 10.3389/fcimb.2018.00124. PubMed DOI PMC

Lazar V., Ditu L.M., Curutiu C., Gheorghe I., Holban A., Popa M., Chifiriuc C. Impact of dental plaque biofilms in periodontal disease: Management and future therapy. In: Arjunan P., editor. Periodontitis: A Useful Reference. InTech Open; London, UK: 2017. pp. 11–42.

Bansal M., Rastogi S., Vineeth N.S. Influence of Periodontal Disease on Systemic Disease: Inversion of a Paradigm: A Review. J. Med. Life. 2013;6:126–130. PubMed PMC

Wolf H.F., Hassell T.M., Rateitschak-Plüss E.M., Rateitschak K.H. Color Atlas of Dental Medicine: Periodontology. Thieme Verlagsgruppe; Stuttgart, Germany: 2005.

Gjermo P. CPITN as a Basic Periodontal Examination in Dental Practice. Int. Dent. J. 1994;44:547–552. PubMed

Cutress T.W., Ainamo J., Sardo-Infirri J. The Community Periodontal Index of Treatment Needs (CPITN) Procedure for Population Groups and Individuals. Int. Dent. J. 1987;37:222–233. PubMed

World Health Organization Oral Health. [(accessed on 25 January 2018)];2012 Available online: http://www.who.int/mediacentre/factsheets/fs318/en.

Slot D.E., Wiggelinkhuizen L., Rosema N.A.M., Van der Weijden G.A. The Efficacy of Manual Toothbrushes Following a Brushing Exercise: A Systematic Review. Int. J. Dent. Hyg. 2012;10:187–197. doi: 10.1111/j.1601-5037.2012.00557.x. PubMed DOI

Berkman N.D., Sheridan S.L., Donahue K.E., Halpern D.J., Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann. Intern. Med. 2011;155:97–107. doi: 10.7326/0003-4819-155-2-201107190-00005. PubMed DOI

Nielsen-Bohlman L., Panzer A., Kindig D., editors. Health Literacy: A Prescription to End Confusion. National Academic Press; Washington, DC, USA: 2004. PubMed

Baker D.W., Wolf M.S., Feinglass J., Thompson J.A., Gazmararian J.A., Huang J. Health Literacy and Mortality among Elderly Persons. Arch. Intern. Med. 2007;167:1503–1509. doi: 10.1001/archinte.167.14.1503. PubMed DOI

Holtzman J.S., Atchison K.A., Macek M.D., Markovic D. Oral Health Literacy and Measures of Periodontal Disease. J. Periodontol. 2017;88:78–88. doi: 10.1902/jop.2016.160203. PubMed DOI PMC

Batista M.J., Lawrence H.P., de Sousa M.d.L.R. Oral Health Literacy and Oral Health Outcomes in an Adult Population in Brazil. BMC Public Health. 2017;18:60. doi: 10.1186/s12889-017-4827-1. PubMed DOI PMC

VanWormer J.J., Tambe S.R., Acharya A. Oral Health Literacy and Outcomes in Rural Wisconsin Adults. J. Rural Health. 2019;35:12–21. doi: 10.1111/jrh.12337. PubMed DOI

Blizniuk A., Ueno M., Furukawa S., Kawaguchi Y. Evaluation of a Russian Version of the Oral Health Literacy Instrument (OHLI) BMC Oral Health. 2014;14:141. doi: 10.1186/1472-6831-14-141. PubMed DOI PMC

Kojima A., Ekuni D., Mizutani S., Furuta M., Irie K., Azuma T., Tomofuji T., Iwasaki Y., Morita M. Relationships between Self-Rated Oral Health, Subjective Symptoms, Oral Health Behavior and Clinical Conditions in Japanese University Students: A Cross-Sectional Survey at Okayama University. BMC Oral Health. 2013;13:62. doi: 10.1186/1472-6831-13-62. PubMed DOI PMC

Kolarcik P., Cepova E., Madarasova Geckova A., Elsworth G.R., Batterham R.W., Osborne R.H. Structural Properties and Psychometric Improvements of the Health Literacy Questionnaire in a Slovak Population. Int. J. Public Health. 2017;62:591–604. doi: 10.1007/s00038-017-0945-x. PubMed DOI

Osborne R.H., Batterham R.W., Elsworth G.R., Hawkins M., Buchbinder R. The Grounded Psychometric Development and Initial Validation of the Health Literacy Questionnaire (HLQ) BMC Public Health. 2013;13:658. doi: 10.1186/1471-2458-13-658. PubMed DOI PMC

Kirch W. CPI (Community Periodontal Index) In: Kirch W., editor. Encyclopedia of Public Health. Springer; Berlin/Heidelberg, Germany: 2008.

Grytten J., Mubarak A. CPITN (Community Periodontal Index of Treatment Needs)—What is its use and what does it Mean? Nor Tannlaegeforen Tid. 1989;99:338–343. PubMed

Kovalcikova A.G., Pancikova A., Konecna B., Klamarova T., Novak B., Kovalova E., Podracka L., Celec P., Tothova L. Urea and Creatinine Levels in Saliva of Patients with and without Periodontitis. Eur. J. Oral Sci. 2019;127:417–424. doi: 10.1111/eos.12642. PubMed DOI

Matuševská M., Kovaľová E. The Influence of Dental Hygiene on Anatomical Structures of the Periodontium under Orthodontic Treatment. Rev. Arg. de Anat. Clin. 2017;9:1–6. doi: 10.31051/1852.8023.v9.n2.17241. DOI

Kovaľová E., Klamárová T., Muller A. Parodontológia = Orálna Hygiena VI.: Definitívne Ošetrenie Poškodeného Parodontu 2. Akcent Print; Prešov, Slovakia: 2015.

Matuševská M., Ferko M. Poradenstvo, Preventívne a Liečebné Odporúčania. Akcent Print; Prešov, Slovakia: 2018. In: 23. dentálny týždeň vo Vysokých Tatrách 2018: Recenzovaný zborník z medzinárodnej vedeckej konferencie.

Kovaľ A. Recenzovaný Zborník 16 Rokov Preventívneho Programu Zdravý Úsmev Na Slovensku, 21 Rokov Vzdelávania V Odbore Dentálna Hygiena v Prešove. Akcent Print; Prešov. Slovakia: 2014. Hodnotenie Úrovne Manažmentu V Zubných Ambulanciách Na Slovensku.