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Research ArticleResearch

Examining Low-income Caregivers’ Knowledge and Comprehension of the Dental Caries Process

Melissa Sullivan, Denise C. McKinney, Deanne Shuman and Qi Zhang
American Dental Hygienists' Association December 2025, 99 (6) 29-39;
Melissa Sullivan
Gene W. Hirschfeld School of Dental Hygiene Old Dominion University Norfolk, VA, USA
PhD, RDH
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  • For correspondence: mlsulliv{at}odu.edu
Denise C. McKinney
Gene W. Hirschfeld School of Dental Hygiene Old Dominion University Norfolk, VA, USA
PhD, RDH, FADHA
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Deanne Shuman
Gene W. Hirschfeld School of Dental Hygiene Old Dominion University Norfolk, VA, USA
PhD, RDH
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Qi Zhang
Joint School of Public Health Old Dominion University Norfolk, VA, USA
PhD
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Abstract

Purpose Dental caries among young children remains a public health concern in the United States (US). Children of caregivers with low oral health literacy (OHL) tend to have greater unmet dental needs and poorer oral health status. The purpose of this study was to examine the understanding of pediatric dental terms associated with the dental caries process among low-income caregivers.

Methods This study included 14 caregivers with children enrolled in a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the Southeastern US. Through structured phone interviews, the validated Oral Health Literacy Inventory for Parents (OH-LIP) was used to measure term recognition, vocabulary knowledge and comprehension of eight terms related to the dental caries process (i.e., acid, hidden sugars, plaque). Two researchers completed the scoring of the inventory and were calibrated on an adapted scoring guide. Content analysis and descriptive statistics were used for synthesizing responses on the OH-LIP inventory and a questionnaire, respectively.

Results Term recognition (OH-LIP part I) scores were high with the majority of caregivers correctly pronouncing the 36 pediatric dental-related terms on the inventory. For the eight terms related to the dental caries process, vocabulary knowledge and comprehension (OH-LIP part II & III) scores were low to moderate, with 0 - 50% of participants providing a fully correct response. Furthermore, there was an observed decrease in scores for all eight terms related to the dental caries process from word recognition to comprehension.

Conclusion This group of low-income caregivers had high word recognition scores for terms related to the dental caries process, indicating an initial high level of OHL. However, vocabulary knowledge and comprehension scores indicated minimal understanding of the same terms. These findings highlight the need for tailored oral health education and messaging that is easily understood for caregivers of young children.

Keywords
  • caregivers
  • oral health literacy
  • dental caries
  • children
  • preventive behaviors
  • WIC
  • Received April 29, 2025.
  • Accepted August 12, 2025.
  • Copyright © 2025 The American Dental Hygienists’ Association
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American Dental Hygienists' Association: 99 (6)
American Dental Hygienists' Association
Vol. 99, Issue 6
December 2025
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Examining Low-income Caregivers’ Knowledge and Comprehension of the Dental Caries Process
Melissa Sullivan, Denise C. McKinney, Deanne Shuman, Qi Zhang
American Dental Hygienists' Association Dec 2025, 99 (6) 29-39;

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Examining Low-income Caregivers’ Knowledge and Comprehension of the Dental Caries Process
Melissa Sullivan, Denise C. McKinney, Deanne Shuman, Qi Zhang
American Dental Hygienists' Association Dec 2025, 99 (6) 29-39;
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Keywords

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  • children
  • preventive behaviors
  • WIC

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