Exploring the influence of oral health literacy and oral health chronic disease knowledge on older adults oral care behaviours

Unlike previous generations, baby boomers are keeping their own natural teeth as they enter into older age. There is a growing body of research demonstrating the link between oral diseases and common chronic diseases. Therefore, it is imperative that older adults possess the necessary skills and knowledge, and participate in preventive oral health behaviours to remain healthy. The purpose of this exploratory, mixed-methods online study was to explore the influence of oral health literacy (OHL) and oral health chronic disease knowledge (OHCDK) on oral care behaviours (OCBs). A convenience sample of 69 community dwelling men (n=19) and women (n=50) was recruited to participate in the Oral Health Chronic Disease Knowledge Study. This Internet based study utilized 4 separate questionnaires: The Oral Health Literacy-Adult Questionnaire, The Oral Health Chronic Disease Knowledge Questionnaire, The Background Information Questionnaire, and The Oral Care Behaviours Survey. Findings from The Oral Care Behaviours Survey were further categorized to create the dependent variable: dental care behaviours, and the independent predictor variable: home dental aid use behaviour group. In addition, qualitative data was collected through the use of 9 open-ended questions. Participants ranged in age from 50 to 69 years, and were further subdivided into early boomers (n=34) with an average age of 63.9, and late boomers (n=35) with an average age of 54.4. All participants had achieved higher than high school education; over half of all participants (52 %) reported living in an urban setting, and 46 % had an annual household income of greater than $75,000. All participants had some natural teeth and 72 % had access to private dental insurance. The mean OHL score for the total sample was 13.36, 95% CI [12.62, 14.10] and the mean OHCDK score was 10.01, 95% CI [9.13, 10.89]. Based on a Pearson product moment correlation co-efficient procedure there was a low but positive correlation between total population OHL and OHCDK scores [r = 0.31, n =69, p = 0.008]. A dental care behaviours score was determined by adding together individual's total points related to the self-reported frequency of dental visits plus frequency of brushing and frequency of flossing. Scores could range from a maximum of 10 to a minimum score of 3, and higher scores denote less participation in positive dental care behaviours. The mean dental care behaviours score was 5.60, 95% CI [5.36, 5.84]. A backward step regression analysis determined the significant predictor model for dental care behaviours included: (1.46) dental insurance + (0.85) age cohort + (0.6) level of education. (F(3) = 311.87, p = < 0.0001, R2 = 93.5%). Early boomers with some college/trade school education and access to private dental insurance had better dental care behaviours scores. Qualitative content analysis revealed five major themes: relying on dental professionals, knowing part of the story, living with the consequences, practicing and valuing oral health, and identifying barriers to care. Triangulation of both data sets supported the findings that participants had adequate OHL, yet were lacking in OHCDK. Comparing and contrasting of the data further highlighted the influential role that private dental insurance has on dental care behaviours. Future research should focus on a larger sample sizes from diverse socioeconomic backgrounds with equal numbers of men and women. It would be beneficial to conduct focus groups to gain further insight into what factors baby boomers believe will impact their future access to dental care.