Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 participants (mean age 36.3 (SD 12.9); 51% female), women reported brushing their teeth more frequently ( ) and scored higher for oral health literacy (mean 10.9 versus 10.2, ). In the adjusted model, high age (OR = 1.01, 95% CI 1.003–1.034), low education (OR = 1.88, 95% CI 1.23–2.87), small living area in square meters per person (OR = 1.85, 95% CI 1.003–3.423), poor tooth brushing behavior (OR = 3.35, 95% CI 2.02–5.57), and low oral health literacy scores (OR = 1.58, 95% CI 1.02–2.45) were significant risk indicators for poor self-reported oral health. Conclusions. Low oral health literacy level, independent of education and other socioeconomic determinants, was a predictor for poor self-reported oral health and should be considered a vital determinant of oral health in countries with developing health care systems. 1. Introduction Discrepancies in oral health status result from numerous obstacles ranging from social [1], environmental [2], biological, behavioural [3], cultural, economic, and political factors [3, 4], to limited access to oral health care services, complicated oral health care systems, a lack of oral-health-information material [5], and oral heath literacy [6]. The process of acquiring oral health information, appraising its concepts, and applying oral health prevention and treatment plans appropriately requires new skill development called oral health literacy (OHL) [6]. Oral health literacy is an interplay between culture and society, the health system, education system, and oral health outcomes [5, 7] indicating that it may be a new determinant of oral health and should be considered more intensively in oral health research. Although current research reveals that oral health literacy is associated with the level of education [8, 9], ethnic group [9, 10], dental service utilization, oral health knowledge, and oral self-care behaviour [11], but knowledge about the impact of oral health literacy on oral health outcomes is scarce [12, 13]; moreover, little is known about this association in countries with developing health care systems such as Iran. A
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