Health information understanding signifies oral health literacy as the essential factor which determines personal capabilities regarding oral health maintenance. General health literacy includes OHL which affects how people understand and behave regarding oral health care management (1). According to the World Health Organization (WHO) people demonstrate health literacy when they gain access to health information through processing and evaluation and eventually use this knowledge to make informed choices about their health until their death (2). The definition of oral health literacy describes an individual's ability to acquire oral health information alongside processing this information and its associated services for making apt oral health choices (3).

A substantial number of people in rural settings alongside other areas suffer from poor oral health literacy despite increased worldwide oral health education thus affecting their dental health status alongside their ability to get proper dental care (4,5). Health care studies reveal that OHL insufficiency produces worse oral health alongside reduced preventive service use and neglected dental problems which diminishes OHRQoL (6,7). People who have poorly educated oral health know how to use healthcare resources more because they delay treatments for their neglected oral health problems (8).

The extensive population of India manages severe issues in oral health literacy promotion because rural areas keep facing minimal awareness together with economic barriers and healthcare service scarcity (9). The primarily rural population and inferior healthcare facilities and limited literacy in Rajasthan creates ideal conditions for studying how OHL affects oral health results (10). Historically OHL assessment tools failed to deliver culturally valid or linguistically accurate measurements because of their absence (11). The Health Literacy in Dentistry (HeLD) scale functions as a validated instrument to evaluate OHL which allows researchers to measure literacy levels through its association with oral health-related quality of life (12).

Several instruments have been developed to measure oral health literacy, including the Rapid Estimate of Adult Literacy in Dentistry (REALD-99, REALD-30), the Test of Functional Health Literacy in Dentistry (TOFHLiD), and the Health Literacy in Dentistry (HeLD) scale (13). REALD and TOFHLiD measure word recognition and reading comprehension but HeLD provides complete evaluation of oral health literacy that includes communication and access barriers together with economic challenges and services use (14). The HeLD scale has demonstrated excellent applications across multiple populations which include indigenous and underserved groups thus making it a strong assessment instrument for rural Indian oral health literacy (15).

A researcher designed cross-sectional investigation utilized the Health Literacy in Dentistry (HeLD) scale to measure oral health literacy among the rural community of Jaipur District, Rajasthan. The Department of Public Health Dentistry at NIMS Dental College within NIMS University performed this investigation at their Jaipur location.

The northern Indian location contains Jaipur which serves as the main capital of Rajasthan. Each of the 15 blocks in the district contains many individual villages as parts. The historical Amer block functions as the study area containing a total of 22 villages.

The researchers conducted the study throughout one year from August 2016 until July 2017 with a preceding pilot study. The data collection phase lasted through three days per week during the period from January 1, 2017 to March 31, 2017.

The simple random sampling method determined the four villages Kanwarpura, Achrol, Kant, and Chitanoo to become the target population. The researchers included 240 participants who came from 60 individuals in each of the four villages.

Inclusion Criteria

1. Individuals aged 18 years and above.
2. Participants able to read and write in either English or Hindi.

Exclusion Criteria

1. Individuals who submitted incomplete questionnaires.
2. Non-residents of the study area.
3. Individuals with physical or intellectual disabilities that could hinder participation.

A multistage random sampling technique was employed. In the first stage, Amer Block was randomly Estimate of Adult Literacy in Dentistry (REALD-99, REALD-30), the Test of Functional Health Literacy in Dentistry (TOFHLiD), and the Health Literacy in Dentistry (HeLD) scale (13). REALD and TOFHLiD measure word recognition and reading comprehension but HeLD provides complete evaluation of oral health literacy that includes communication and access barriers together with economic challenges and services use (14). The HeLD scale has demonstrated excellent applications across multiple populations which include indigenous and underserved groups thus making it a strong assessment instrument for rural Indian oral health literacy (15).

Materials and Methods

A researcher designed cross-sectional investigation utilized the Health Literacy in Dentistry (HeLD) scale to measure oral health literacy among the rural community of Jaipur District, Rajasthan. The Department of Public Health Dentistry at NIMS Dental College within NIMS University performed this investigation at their Jaipur location.

The northern Indian location contains Jaipur which serves as the main capital of Rajasthan. Each of the 15 blocks in the district contains many individual villages as parts. The historical Amer block functions as the study area containing a total of 22 villages.

The researchers conducted the study throughout one year from August 2016 until July 2017 with a preceding pilot study. The data collection phase lasted through three days per week during the period from January 1, 2017 to March 31, 2017.

The simple random sampling method determined the four villages Kanwarpura, Achrol, Kant, and Chitanoo to become the target population. The researchers included 240 participants who came from 60 individuals in each of the four villages

The study assessed oral health literacy using the HeLD scale and oral health-related quality of life The research evaluated OHIP-14 performance in the rural Jaipur District population. The researchers evaluated the results through analysis of different demographic and socio-economic characteristics.

A total of 240 participants took part in the research and consisted of 168 males who made up 70% of the group and 72 females representing 30% of the population. The study participants evaluated 29.91 ± 6.73 years of age on average as male respondents (Table 1) and 27.51 ± 5.32 years of age on average as female participants.

The research used socioeconomic classification segments to analyze participants and identified important differences in oral health literacy scores between groups. Participants defined as upper middle class achieved the largest HeLD score at 82.53 ± 13.88 while middle class participants scored 70.58 ± 14.41 and the lower middle class scored the least at 55.64 ± 10.95. The HeLD scores between socioeconomic groups produced meaningful statistical results (p < 0.001) according to Table 2.

Each socioeconomic group demonstrated distinct variations in their OHIP-14 score results. The individuals in the lower middle class achieved the worst oral health-related quality of life results recorded by the OHIP-14 score reaching 16.78 ± 4.97 whereas the upper class obtained 7.00 ± 0.00 as their lowest score according to OHIP-14 (Table 2). Statistical calculations demonstrated this variation had significant importance (p = 0.013).

The results showed a negative weak relationship between HeLD and OHIP-14 scores (Pearson’s correlation coefficient = -0.193, p = 0.003) indicating better oral health-related quality of life accompanies higher oral health literacy (Table 3).

Table 1: Distribution of Study Population Based on Age and Gender

Table 2: Mean HeLD and OHIP-14 Scores Among Different Socioeconomic Groups

(p < 0.001 for HeLD, p = 0.013 for OHIP-14; Source: Study Data)

Table 3: Correlation Between HeLD and OHIP-14 Scores

The findings indicate that oral health literacy is significantly associated with socioeconomic status and has a weak negative correlation with oral health-related quality of life (Table 3). Higher oral health literacy levels were associated with lower OHIP-14 scores, reflecting better oral health outcomes.

General health literacy contains oral health literacy as an essential component because it determines a person's access to and understanding and practical use of dental information for preventing and managing diseases. The factor determines oral health standards effectively while it intensifies health inequality and specifically impacts rural residents with limited education and money (1,2). Research evaluated oral health literacy through Health Literacy in Dentistry (HeLD) scores found among the rural Jaipur District residents and established its relationship with oral health-related quality of life (OHRQoL).

The research revealed that OHL did not have statistical connections with age or gender which confirms findings from other population-based studies (3,4). Research studies indicate that cognitive decline together with lower education levels commonly lead older adults to possess lower health literacy levels (5). The variable age distribution among study participants might explain why no significant relationship existed between OHL and other variables.

The socioeconomics of study participants played a strong role in determining their OHL scores because persons from wealthier backgrounds displayed superior oral health literacy (p<0.001). Health literacy among individuals with higher income and education levels shows consistent patterns based on two prior reports that link superior health literacy to more frequent preventive oral health actions (6,7). The research strengthens understanding that poverty and insufficient education historically block the ability to obtain oral health information and this leads to unsatisfactory oral health results (8).

The assessment scores from HeLD and OHIP-14 indicated a negative association (r=-0.193, p=0.003) which demonstrated superior quality of life through better OHL. Health research previously confirmed that individuals with limited health literacy tend to have worse oral health status ratings while they experience higher dental anxiety and use dental services at lower levels (9,10). People with poor OHL demonstrate lesser likelihood to grasp preventive dentistry knowledge and identify dental disease indicators and schedule appropriate dental appointments thus deteriorating OHRQoL (11,12).

The research data showed that participants using daily toothbrushing and toothpaste possession demonstrated superior OHL scores to participants without these oral hygiene tools (13). Multiple studies document that people with better health comprehension also practice proper oral hygiene routines and maintain regular dental appointments (14,15). The analysis shows that rural communities need specific oral healthcare educational programs which will enhance their oral care routines.

Research results show the need for community-based programs which focus on raising oral health literacy levels within populations whose income is low and educational background is minimal. Cultural suitability and simplified educational resources need development to create effective interventions for oral health literacy promotion in schools, healthcare facilities and community outreach programs (16). Primary healthcare services demonstrate improved oral health education outcomes by integrating such programs (17).

The research design as cross-sectional restricted scientists from proving cause-effect relationships. Self-reported measurements have the potential to cause response bias to influence study results. New research should investigate through long-term follow-ups the effects that oral health literacy programs have on oral health results. Qualitative research methods enable researchers to understand better the barriers which limit oral health literacy along with factors that support its growth in rural areas (18,19).

The research demonstrates how socioeconomic conditions influence oral health literacy and affect health-related personal quality assessments. Public health needs to direct its efforts toward raising oral health literacy because underserved rural populations require specific intervention. Assessing and actively addressing health literacy gaps with educational programs and policy changes and community-included health initiatives aims to improve both oral health results and general well-being.

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