Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta‐analysis

Objectives To conduct a systematic review and meta‐analysis regarding the association of oral health literacy (OHL) with oral health behaviors, perception, knowledge, and dental treatment related outcomes. Methods Eight electronic databases were searched up until June 2017. Studies regarding the aforementioned outcomes measuring OHL through a validated instrument and in which OHL was an explanatory variable were included. Two independent reviewers selected studies, extracted data, and analyzed the risk of bias of the studies. Meta‐analysis using random effect modeling was undertaken. Pooled estimates were calculated with 95 percent confidence interval (CI) and odds ratios (OR). Results Twenty‐five studies were included in the systematic review and three in the meta‐analysis. Most studies were cross‐sectional (n = 21) and had a high risk of bias (n = 17). The meta‐analysis showed no association between OHL and frequency of visit to the dentist for adults, either through bivariate analysis (OR = 1.25; 95 percent CI: 0.95‐1.63) or multivariate analysis (OR = 1.90; 95 percent CI: 0.77‐4.84). Dental anxiety and night bottle‐feeding were associated with low OHL (P