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J Dent Hyg. 2011 Winter;85(1):49-56. Epub 2011 Jan 1.

Knowledge of oral health issues among low-income Baltimore adults: a pilot study.

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Division of Health Services Research, Department of Health Promotion and Policy at the University of Maryland Dental School, USA.



This pilot study documents conceptual knowledge of oral health among low-income adults in Baltimore.


Selected questions from the Baltimore Health Literacy and Oral Health Knowledge Project, a cross-sectional, population-based investigation of oral health literacy, were used for this analysis. Participants were asked questions during face-to-face interviews about basic oral health and the prevention and management of dental caries and periodontal diseases. Descriptive analyses included tests of association with selected socio-demographic variables (age, sex, education level, annual household income).


The majority of respondents were African American women, 45 to 64 years of age, with 12 years of education and an income less than or equal to $25,000. Ninety-one percent of respondents knew that sugar caused dental caries, while 82% understood that the best way to prevent tooth decay was to brush and floss every day. Knowledge of oral hygiene practices and the prevention and management of gingivitis and periodontitis was mixed. Seventy-six percent understood that the best way to remove tartar was by a dental cleaning. However, only 15% knew how often to floss their teeth and only 21% knew that plaque was composed of germs.


Conceptual oral health knowledge is one component of oral health literacy. In turn, oral health literacy impacts communication. Practitioners should account for limited conceptual knowledge when they discuss oral health issues with their low-income and minority patients. If this is not accounted for, they will probably find that their oral hygiene education messages are being ignored and health promotion is being adversely affected.

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