The mediating effect of health information literacy on the relationship between oral examination and oral health problems in Korean adults: Findings from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES)

Abstract

This study investigated the association between oral health examinations and oral health problems among Korean adults, and whether health information literacy mediates this relationship. A cross-sectional analysis using semi-structured interviews was conducted with 5,645 adults aged 19 years and older from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), which newly included a standardized measure of health literacy. Oral health problems (difficulties with chewing and speaking) and health literacy (10-item self-reported scale) were assessed. Mediation was tested using the Sobel test and PROCESS macro Model 4.Individuals who received oral examinations had significantly higher health information literacy and fewer oral health problems (p < 0.001). Mediation analysis revealed that health information literacy partially mediated this association. In the adjusted model, oral examination was significantly associated with higher health information literacy (β = 0.730, p < .001) and lower oral health problems (β = −0.119, p = 0.011). Health literacy was also significantly associated with oral health problems (β = −0.041, p < .001), confirming the mediation effect. The indirect effect was −0.030 (bootLLCI = −0.044, bootULCI = −0.018). These findings indicate that health information literacy partially mediates the relationship between oral examinations and oral health problems. Promoting preventive dental care and improving health information literacy may help reduce oral health disparities and enhance overall health outcomes.