Teachers’ health literacy and oral health education in public schools: a mixed-methods study

Introduction: Health literacy (HL) integrates health information and its application in real-life contexts through conscious choices that lead to healthy behaviors. It is not clear how teachers’ HL fosters an educational environment that promotes oral health within school communities. Objective: This mixed-methods study examined the relationship between teachers' HL and pedagogical processes in oral health education in public schools. Method: In the quantitative phase, we examined the HL and Oral Health Literacy (OHL) levels of 181 early childhood and elementary school teachers. In the qualitative phase, twelve teachers from nine schools were interviewed about their pedagogical practices, focusing on curative/biomedical, preventive, and health-promotion approaches. To integrate the data, the researchers developed a matrix based on the socioecological model. Result: The overall mean of HL was 2.91 (0-4 scale). The Disease Prevention dimension had the highest mean (3.04), while Health Promotion had the lowest (2.73). The difficulties included managing mental health information and media-conveyed information, as well as financial barriers to dental consultations. The reported educational practices encompassed the biomedical, preventive, and health-promotion approaches, operating at the individual, school, community, and public policy levels, and coexisting and complementing one another in oral health education within the school environment. Conclusion: Teachers' HL and OHL levels are reflected in the nature, scope, and depth of the educational practices they implement. The findings highlight the importance of continuous teacher training and closer collaboration between education and health services, as public policy.