Oral Health Literacy and Periodontal Status Among Turkish Adults

January 6, 2026 updated by: Burcu KARADUMAN, Biruni University

Association Between Oral Health Literacy and Periodontal Status Among Turkish Adults: A Cross-Sectional Study

This observational cross-sectional study aimed to investigate the association between oral health literacy (OHL) and periodontal status among adult individuals attending Biruni University Faculty of Dentistry, Istanbul, Türkiye. A total of 108 adults were evaluated using the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) to assess OHL levels. Periodontal examination included probing depth, clinical attachment level, bleeding on probing, and plaque index. The study sought to determine whether lower OHL levels are associated with poorer periodontal health and to highlight the importance of improving health literacy in oral disease prevention and management.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This cross-sectional observational study was conducted at Biruni University Faculty of Dentistry, Istanbul, Türkiye, to evaluate the relationship between oral health literacy (OHL) and periodontal status among adult individuals. A total of 108 systemically healthy adults aged 18 years or older were included. Individuals with fewer than 20 teeth, history of periodontal treatment in the past 6 months, or systemic diseases affecting periodontal health were excluded.

OHL was assessed using the validated Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30). Periodontal examination was performed by a calibrated periodontist and included full-mouth probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). Periodontitis was defined according to the 2018 World Workshop classification system.

The primary objective was to determine whether limited OHL is associated with worse periodontal parameters. Secondary objectives included evaluating the relationship between OHL and sociodemographic variables such as age, education, and smoking habits. Statistical analyses were performed using regression models to identify independent predictors of periodontal disease.

The findings of this study aim to emphasize the role of oral health literacy as a potential social determinant of periodontal health and to guide the development of literacy-based preventive strategies in dental public health.

Study Type

Observational

Enrollment (Actual)

108

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye), 34010
        • Biruni University Faculty of Dentistry, Department of Periodontology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study included 108 systemically healthy adults aged 18 years or older who attended the Periodontology Clinic of Biruni University Faculty of Dentistry, Istanbul, Türkiye. Participants were native Turkish speakers, able to read and understand Turkish, and provided informed consent. Each participant completed the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) to assess oral health literacy. Periodontal examinations were performed by a calibrated periodontist and included probing depth, clinical attachment level, bleeding on probing, and plaque index measurements. Individuals with systemic diseases, fewer than 20 teeth, or cognitive or literacy limitations preventing questionnaire completion were excluded.

Description

Inclusion Criteria:

Systemically healthy adults aged 18 years or older

Ability to read and understand Turkish

Voluntary agreement to participate in the study

Exclusion Criteria:

Individuals with fewer than 20 teeth

History of periodontal treatment within the past 6 months

Presence of systemic diseases affecting periodontal health

Individuals with mental retardation, cognitive impairment, or inability to complete the questionnaire due to illiteracy or communication difficulties

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Adult Participants
A single observational group including adult individuals who attended Biruni University Faculty of Dentistry, Istanbul, Türkiye. All participants underwent a full-mouth periodontal examination and completed the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) questionnaire. No intervention or treatment was provided as part of the study.
Other: Observational Assessment
No intervention was performed. Participants underwent a non-invasive periodontal examination and completed the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) questionnaire to assess oral health literacy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Association between oral health literacy and periodontal status
Time Frame: Baseline (single examination at enrollment)
The primary outcome is the relationship between oral health literacy, measured by the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30), and periodontal status based on the 2018 World Workshop classification. Periodontal parameters include probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP).
Baseline (single examination at enrollment)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Association between oral health literacy and demographic factors
Time Frame: Single time point (baseline examination)
To assess the association between oral health literacy levels and demographic characteristics such as age, gender, and educational attainment among adult participants.
Single time point (baseline examination)
Relationship between oral health literacy and smoking status
Time Frame: Single time point (baseline examination)
To determine whether smoking habits are associated with lower oral health literacy scores and poorer periodontal parameters.
Single time point (baseline examination)
Association between oral health literacy and oral hygiene behaviors
Time Frame: Single time point (baseline examination)
To evaluate the relationship between oral health literacy (measured by the TREALD-30) and self-reported oral hygiene practices, including toothbrushing frequency, use of interdental cleaning aids, and frequency of dental visits.
Single time point (baseline examination)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Biruni University

Investigators

  • Study Director: Burcu Karaduman, DDS, PhD, Biruni University Faculty of Dentistry

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2021

Primary Completion (Actual)

June 30, 2022

Study Completion (Actual)

July 31, 2024

Study Registration Dates

First Submitted

January 6, 2026

First Submitted That Met QC Criteria

January 6, 2026

First Posted (Actual)

January 15, 2026

Study Record Updates

Last Update Posted (Actual)

January 15, 2026

Last Update Submitted That Met QC Criteria

January 6, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024-BIAEK/12-14 (Other Identifier: Biruni University Non-Interventional Ethics Committee (Istanbul, Türkiye))

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because this observational study involves identifiable clinical and questionnaire data collected under institutional ethics approval, which restricts public data sharing due to privacy and confidentiality considerations.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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