Caracterización de la alfabetización en salud bucal en una población de adultos mayores

Resumo

Background: The improvement of the average life expectancy has caused an increase in the elderly population and with this, arises the need to study this population better in terms of its health in general and specifically in terms of oral health. Health literacy is a main factor in health improvement, allowing individuals to have a greater capacity to commit and participate in collective actions to promote health. It is essential to characterize their oral health status and determine each individual's ability to understand basic health information. Aim: The present study aims to characterize oral health, the type of oral rehabilitation and assess the level of literacy in oral health in a group of elderly populations. Also, the assessment of the association between oral health literacy, oral health condition and respective perception of oral health and quality of life in the study group. It was also an objective of the study to carry out the translation and transcultural adaptation of the rapid estimation of adult literacy in dentistry (REALD-30) into Portuguese and to test the reliability and validity of this version. Materials and methods: A cross-sectional observational study was designed on a group of 206 individuals. The study was approved by the Health Ethics Committee of the Universidade Católica Portuguesa. All individuals were clinically evaluated, and a questionnaire was applied, in the form of a “face to face” interview with questions related to the quality of life related to oral health (GOHAI and OHIP-14) and the REALD-30 scale to assess oral health literacy level. Results: The Rapid Estimation of Adult Literacy in Dentistry-29 PT presented good internal reliability. Cronbach's alpha oscillated between 0.89 and 0.90 when words were eliminated individually. Test-retest reliability analysis revealed excellent reproducibility. We can confirm that the Rapid Estimation of Adult Literacy in Dentistry-29 PT scale for the assessment of oral health literacy among older adults presents an acceptable internal consistency, with a global Cronbach's alpha of 0.894. Of the 206 study participants, 90.3% admit to toothbrushing daily, and 6.3% admit to use daily dental floss. Applying the REALD-30 scale, 22.7% had a low level (score 0-14), 43.7% had a moderate level (score 15-22) and 33.6% had a high level (score 23- 29). The GOHAI scale reveals that 37.4% have a high self-perception of their oral health, 32% moderate and 30.6% have a low self-perception of their oral health. Gender was associated with toothbrushing (p=0.013) and the use of dental prosthesis (p=0.039); age was associated with the frequency of dental appointments in the last 12 months (p=0.024) and the use of dental prostheses (p=0.04); high self-perception of oral health with dental pain (p<0.001); Severe periodontitis is also associated with episodes of dental pain (p=0.003) and moderate periodontitis with low GOHAI values (p=0.034). Conclusion: The new scale can be applied to assess oral health literacy among older Portuguese adults, presenting an acceptable internal consistency and is validated to evaluate oral health literacy which is crucial in epidemiological studies. Educating each person about their oral health by participating in a specific health program and developing proposals for activities to promote oral health should be widely considered as a main objective in primary prevention, especially among people over 65 years old, where we can see worse oral health results, health behaviors and quality of life.