• Iran;
  • oral health;
  • oral health literacy;
  • reliability;
  • validity



The aim of the present study was to develop a functional oral health literacy (OHL) instrument for adults, including new measures of literacy skills (OHL Adults Questionnaire: OHL-AQ).


An item pool was provided, and an expert panel evaluated the items by assessing the content validity index and content validity ratio. The reliability analysis, including internal consistency and reproducibility, were examined using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). In addition a known-groups comparison was performed to assess how well the questionnaire discriminates between individuals who differ in education and brushing behavior.


A total of 97 participants were studied. The mean age of the participants was 36.3 (standard deviation [SD] = 12.8) years; 34% had more than 12 years' formal education. Overall, 39.2% of interviewees had inadequate, 16.5% had marginal, and 44.3% had adequate OHL. The internal consistency, as measured by Cronbach's alpha, was found to be 0.72, and the ICC was 0.84. Participants who brushed more frequently had significantly higher OHL scores (= 0.03). The association between OHL scores and years of education was also significant (< 0.001).


The OHL-AQ is a valid and reliable measure of functional OHL, with additional sections for evaluating listening and decision-making skills.