Decadal comparison of Oral Health Literacy among the employees of Udupi taluk postal division, Karnataka state, India – A Cross-sectional study

Decadal comparison of Oral Health Literacy among the employees of Udupi taluk postal division, Karnataka state, India – A Cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Decadal comparison of Oral Health Literacy among the employees of Udupi taluk postal division, Karnataka state, India – A Cross-sectional study Polavarapu Venkata Abhinaya, Ramprasad Vasthare, Manjula Anil Kunder, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7886188/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Introduction: Oral health literacy (OHL) is an important factor that affects oral health outcomes. Postal employees display distinct patterns of oral health literacy due to their work routine and exposure. Monitoring changes in oral health literacy can help develop targeted interventions. The study aimed to compare oral health literacy among postal employees of Udupi taluk. Materials and Methods A cross-sectional study was conducted among postal employees in Udupi Taluk using a standardized questionnaire to assess oral health literacy. Socio- demographic variables and self-reported oral health behaviors were also recorded, followed by statistical analysis to identify trends and correlations. Results The findings indicate no significant variation in OHL across different decades (p > 0.05). The highest OHL is observed in the 21–30 decade group (11.8 ± 1.81), while the lowest is in the 41–50 decade group (10.4 ± 2.30). Conclusion The results suggest increased oral health awareness due to improved access to healthcare information and public health initiatives. Oral health literacy Postal service Attitudes Cross-sectional study Figures Figure 1 Introduction Health literacy, as defined by WHO, encompasses the knowledge and skills developed through everyday activities, social interactions, and intergenerational relationships. Organizational structures and resource availability influence these competencies, enabling individuals to access, comprehend, evaluate, and use information and services to promote and maintain their health and well-being (1) . It is a compound term used to describe people's abilities to handle the complex health demands in modern society (2) . Oral health literacy refers to the ability of individuals to obtain, process, and understand essential oral health information and services necessary for making informed health decisions (3) . Individuals with lower levels of health literacy tend to underutilize preventive screenings, have poorer adherence to medical advice, misuse medications, face higher healthcare costs, experience more frequent hospitalizations, depend more on emergency services, and face an increased risk of mortality (4) . Poor oral health arises from multiple factors, including biological characteristics, socioeconomic conditions, nutritional and oral hygiene beliefs and practices, as well as physical and cognitive skills that impact the uptake of preventive practices. Likewise, limited oral health literacy, which involves an individual’s motivation and ability to access, understand, and use health information, plays a significant role in poor oral health outcomes (5) . Although education is strongly associated with reading skills, educational level by itself is not a sufficient predictor of health literacy. Therefore, we used the Adult Oral Health Literacy (OHL) instrument developed by Sistani et al (6) . This instrument incorporates a new set of literacy measures, the Adult-Oral Health Literacy Questionnaire, which includes a dental word recognition component consisting of 17 items. Domestic e-commerce deliveries predominantly rely on the efficiency and reliability of national postal services. Given the essential economic role the postal workers play in facilitating e-commerce and maintaining service standards, it is imperative to thoroughly assess and understand the oral health literacy levels among postal employees across all job designations. Research conducted by Das et al. (7) used a bilingually adapted Hindi Oral Health Literacy tool. Among the study participants, 300 (50%) had inadequate oral health literacy, 180 (30%) showed marginal oral health literacy, and only 120 (20%) demonstrated adequate oral health literacy. Females exhibited better oral health literacy compared to males. There is currently no clear information regarding oral health literacy among postal employees in Udupi Taluk. Therefore, the study sought to evaluate Oral Health Literacy levels among postal employees in Udupi taluk and to compare them across different age groups, genders, and job designations. Aims and objectives Aims The study aims to assess the Oral Health Literacy levels among the Postal employees of Udupi taluk, along with a decadal comparison. Objectives To determine oral health literacy among different age groups and genders of postal employees. To determine oral health literacy among different designations of postal employees of Udupi taluk. Materials and Methods A cross-sectional study, conducted in accordance with the STROBE guidelines and SAGER guidelines, was undertaken between June and December 2024 to assess oral health literacy levels among postal employees in Udupi taluk, Karnataka. The study received approval from the KMC and KH Institutional Ethics Committee (IEC2: 375/2024) and was registered with the Clinical Trial Registry of India under the number CTRI/2024/08/071869. Prior written informed consent from parents and verbal assent were obtained from the participants. The study was conducted in accordance with ethical principles of the Declaration of Helsinki in relation to Ethics approval and consent to participate. Inclusion criteria: Participants were postal employees between 25 and 60 years of age, employed in post offices in Udupi taluk, Karnataka, and willing to give informed consent for the study. The Post offices included in the study were: Postmaster of Head Post Office, Udupi, Postmaster of India Post, Manipal, Postmaster of Head Post Office, Krodashrama, Postmaster of Head Post Office, Kunjibettu, Postmaster of Head Post Office, Malpe, Postmaster of Head Post Office, Santhekatte, and Postmaster of Sub Post Office, Ambalpadi Exclusion criteria: Participants unwilling to participate or unable to give informed consent were not included in the study. Study proforma: Participants’ demographic details were collected in the first section of the self-administered questionnaire. The second section assessed oral health practices, including the frequency of tooth brushing, types of oral hygiene aids used, frequency of toothbrush replacement, use of a tongue cleaner, dental floss usage, and habits related to smoking and alcohol consumption. The third section comprised items designed to measure participants’ oral health literacy. Sample size: One hundred ninety-seven employees were working under the various post offices, subunits, and post collection units under Udupi taluk. The statistician’s inputs have been duly taken, and the statistician believes that a complete enumeration of all the postal employees in Udupi taluk will be appropriate. Data Analysis: Descriptive analysis was conducted using SPSS software version 23.0 (SPSS Inc., Chicago, IL, USA). A p-value of ≤0.05 was considered statistically significant. The descriptive data for the sample population were calculated as frequencies and percentages. The association between Oral Health Literacy and all the variables was analyzed using the independent t-test and one-way ANOVA. Results A total of 131 participants (Figure 1) were analysed out of 197 participants. 69 participants declined to participate in the study. Adults aged 25 - 60 years of age, with a mean age of 43.07 ± 9.49 years, and oral health literacy was found to be moderate, with a mean score of 10.9 ± 2.03. The study reported a participation rate of 60.3% among male subjects and 39.7% among female subjects, indicating a dominant presence of male participants in the research. 50.4% were postmen/postwomen, 23.7% were central government employees, 18.3% were postal assistants, 5.3% were postal security workers, and 2.3% were postal clerks. Among the participants, 88.5% were married, while 11.5% were unmarried. (Table 1) Table 1 : Distribution of study participants according to demographic characteristics Frequency (n) Percent (%) Age group 21-30 years 10 7.6 31-40 years 47 35.9 41-50 years 37 28.2 Above 50 years 37 28.2 Gender Male 79 60.3 Female 52 39.7 Occupation Postal assistant 24 18.3 Central Government Employee 31 23.7 Postman/Post woman 66 50.4 Postal Clerk 3 2.3 Postal Security 7 5.3 Education Primary 5 3.8 Highschool/ Diploma 70 53.4 Graduate 56 42.7 Marital status Unmarried 15 11.5 Married 116 88.5 n = number of participants In the study population, 42.7% brushed their teeth 2–3 times daily, whereas the majority, 57.3% brushed only once a day. Furthermore, an impressive 97.7% use a toothbrush with toothpaste, only 2.3% choose chewsticks, neem leaves, or neem chewsticks, and 70.2% change their toothbrush every three months. (Table 2) Table 2 : Oral health practices among the study participants Frequency (n) Percent (%) How often do you brush your teeth? 2-3 times a day 56 42.7 Once a day 75 57.3 What do you use to clean your teeth? Chewsticks/neem leaves/neem chewstick 3 2.3 Toothbrush with toothpaste 128 97.7 How often do you change your toothbrush? Every 3 months once 92 70.2 Every 6 months once 32 24.4 When the brush bristles fall off 7 5.3 How often do you use a tongue cleaner? Never 24 18.3 Once a day 76 58.0 2 times a day (every time after brushing) 21 16.0 d. 2-3 times a week 10 7.6 Do you use dental floss in your daily life? No 119 90.8 Yes 12 9.2 Any habit of smoking / smokeless tobacco? No 128 97.7 Yes 3 2.3 Any habit of drinking Alcohol? No 130 99.2 Yes 1 .8 n=number of participants There was no significant variation in OHL across different age groups (p > 0.05). The highest OHL was reported in the 21-30 decade group (11.8 ± 1.81), while the lowest was in the 41-50 decade group (10.4 ± 2.30). A statistically significant difference exists among gender (p < 0.05), with Females (11.4 ± 1.77) having a higher OHL score compared to males (10.5 ± 2.11). Employees of the Central Government had a higher mean score for OHL (11.6 ± 2.01) compared to other designations among the study participants. (Table 3) Table 3 : Oral health literacy ( Mean + SD ) in comparison with demographic characteristics : OHL Mean ± SD p-value Age group Below 35 years 11.40 ± 1.88 0.29 36-43 years 10.7 ± 2.28 44-51 years 10.4 ± 2.13 Above 51 years 11.0 ± 1.75 Gender Male 10.5 ± 2.11 0.006* Female 11.4 ± 1.77 Occupation Postal assistant 11.2 ± 2.14 0.178 Central Government Employee 11.6 ± 2.01 Postman/Post woman 10.4 ± 2.05 Postal Clerk 11.0 ± 1.00 Postal Security 10.8 ± 0.89 Education Primary 11.0 ± 1.00 0.965 Highschool/ Diploma 10.8 ± 2.20 Graduate 11.0 ± 1.90 Marital status Unmarried 11.0 ± 2.20 0.959 Married 10.8 ± 2.02 Independent t-test One-way ANOVA *P <0.05 was considered significant Discussion Our study explores evolving trends in Oral Health Literacy among postal employees in Udupi Taluk. Results revealed that 22.1% of female participants had higher OHL, which is similar to a study by Sfeatcu ( 8 ) , indicating that women generally exhibit positive attitudes, place a higher value on oral health, practice better oral hygiene behaviours, and possess greater oral health literacy than men. Another study conducted by Lipsky ( 9 ) revealed that women tend to have more favorable attitudes towards dental visits, higher oral health literacy, and engage in better oral health practices. In our study, 97.7% of participants reported that they brush their teeth using a toothbrush and toothpaste. This finding contrasts with a study conducted by Selvaraj ( 10 ) , which indicated that 18.4% of respondents believed keeping teeth clean and healthy has a positive effect on health, and 92% perceived scaling as harmful to their gums. Our findings found only 13.0% of participants aged over 50 demonstrated higher Oral Health Literacy, which aligns with the study conducted by Piyakhunakorn ( 11 ) , which indicated that older individuals tend to have lower education levels. Furthermore, brushing teeth less than twice daily was a statistically significant predictor of lower oral health literacy (OHL) among participants. Our study findings also revealed that 14.5% of central government employees had higher OHL, which is compared to a study by Carrouel ( 12 ) , indicating some public officials in France possessed marginal levels of oral health knowledge and Literacy. Although significant progress has been made in Health Literacy, particularly among employees with minimal education and older age cohorts, they continue to exhibit lower levels of understanding and engagement with oral health concepts. These disparities can often be attributed to several factors, including insufficient access to comprehensive health education programs and the persistence of long- standing habits that resist modification. For example, those with minimal formal education could have restricted access to information on oral health, which can limit their capacity to make informed oral health decisions. Similarly, older adults may have developed entrenched practices that are not easily altered, even in the face of new, evidence-based recommendations regarding oral hygiene and health. Addressing these issues requires targeted educational initiatives and tailored interventions that consider the unique needs and challenges of these groups. By examining the effectiveness of workplace oral health promotion programs, we can identify actionable strategies for improving oral health literacy and help in assessing whether there have been significant shifts in oral hygiene habits, dietary choices, and health-seeking behaviors among postal employees. Limitations of this study include participants often failing to accurately recall their past behaviors or changes in their oral health practices, which leads to significant inaccuracies in self-reported data and creates a clear risk of response bias and social desirability bias. It is essential to tailor oral health literacy programs to specific employee demographics, particularly those with lower educational backgrounds, to effectively close the existing gaps. Employers and policymakers must prioritize the integration of oral health education and preventive dental check-ups into employee wellness programs to promote better overall health outcomes. Conclusion The findings show a shift in knowledge toward oral health among postal employees, likely influenced by better access to healthcare information, public health initiatives, and workplace health programs. Despite improvements in oral health literacy, disparities may persist due to factors like age, educational background, and access to health promotion activities. This research emphasizes the value of implementing tailored oral health education programs for employees, which may substantially improve oral health outcomes. Declarations Ethics approval: Ethical approval obtained from Kasturba Medical College and Kasturba Hospitals, Institutional Ethics Committee – 2 (IEC2: 375/2024) CTRI registration number: CTRI/2024/08/071869 Consent to participate: Informed consent was taken prior to data collection. Consent for publication: Not applicable Availability of data and material (data transparency): Data is available for sharing on appropriate request to the corresponding author. Conflicts of interest/Competing interests: The authors declare that they have no conflicts of interest/competing interests. Funding: Self–funded Authorship contribution statement: Dr PVA – Principal student researcher, data collection, data analysis, interpretation, manuscript writing Dr RVP – Principal investigator, conceptualization of study, intellectual inputs, study co-ordination, manuscript review Dr MAK – Sample size estimation, study design, data analysis, statistical tables and reporting Dr PPN – Study design, data analysis and interpretation, manuscript review and editing Dr JP – Data collection and field visit support, literature compilation Dr AP – Study design, manuscript review, study implementation support Sincere Acknowledgments: Postmaster of Head Post Office, Udupi, Postmaster of India Post, Manipal, Postmaster of Head Post Office, Krodashrama, Postmaster of Head Post Office, Kunjibettu, Postmaster of Head Post Office, Malpe, Postmaster of Head Post Office, Santhekatte, and Postmaster of Sub Post Office, Ambalpadi Health Sciences Library, Manipal Academy of Higher Education, Manipal All the postal employee participants of the study References Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012 Dec 25;12(1):80. Sørensen K, Van Den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: Illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13(1). King S, Thaliph A, Laranjo L, Smith BJ, Eberhard J. Oral health literacy, knowledge and perceptions in a socially and culturally diverse population: a mixed methods study. BMC Public Health. 2023 Dec 1;23(1). Lee CJ, Ho MH, Joo JY, Montayre J, Lin YK, Chang CC, et al. Gender differences in the association between oral health literacy and oral health-related quality of life in older adults. BMC Oral Health. 2022 Dec 1;22(1). Thapa SB, Dramani Kipo-Sunyehzi D. Interplay of health literacy, healthcare access and health behaviors with oral health status among older persons. Naghibi Sistani MM, Montazeri A, Yazdani R, Murtomaa H. New oral health literacy instrument for public health: development and pilot testing. J Investig Clin Dent. 2014 Nov 1;5(4):313–21. Das D, Menon I, Gupta R, Arora V, Ashraf A, Ahsan I. Oral health literacy: A practical strategy towards better oral health status among adult population of Ghaziabad district. J Family Med Prim Care. 2020;9(2):764. Sfeatcu R, Balgiu BA, Mihai C, Petre A, Pantea M, Tribus L. Gender Differences in Oral Health: Self-Reported Attitudes, Values, Behaviours and Literacy among Romanian Adults. J Pers Med. 2022 Oct 1;12(10). Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Vol. 15, American Journal of Men’s Health. SAGE Publications Inc.; 2021. Selvaraj S, Naing NN, Wan-Arfah N, De Abreu MHNG. Assessment on Oral Health Knowledge, Attitude, and Behaviour and its Association with Sociodemographic and Habitual Factors of South Indian Population. Pesqui Bras Odontopediatria Clin Integr. 2021 Oct 22;21. Piyakhunakorn P, Sermsuti-anuwat N. The Associations between Oral Health Literacy and Oral Health-Related Behaviours among Community-Dwelling Older People in Thailand. Glob J Health Sci. 2021 Jan 8;13(3):1. Carrouel F, du Sartz de Vigneulles B, Clément C, Lvovschi VE, Verot E, Tantardini V, et al. Promoting Health Literacy in the Workplace Among Civil Servants: Cross- Sectional Study. JMIR Public Health Surveill. 2024;10. Additional Declarations No competing interests reported. Supplementary Files 03.Graphicalabstract.pptx 05.Questionnaire.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 28 Jan, 2026 Reviews received at journal 25 Jan, 2026 Reviews received at journal 23 Jan, 2026 Reviewers agreed at journal 23 Jan, 2026 Reviews received at journal 22 Jan, 2026 Reviewers agreed at journal 22 Jan, 2026 Reviewers agreed at journal 21 Jan, 2026 Reviewers agreed at journal 21 Jan, 2026 Reviewers invited by journal 21 Jan, 2026 Editor invited by journal 30 Dec, 2025 Editor assigned by journal 26 Nov, 2025 Submission checks completed at journal 26 Nov, 2025 First submitted to journal 26 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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12:41:43","extension":"html","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":82759,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7886188/v1/8324a27d942df751cbcaf504.html"},{"id":100983272,"identity":"6f0696d4-e621-4abe-b8db-768a4ebd9122","added_by":"auto","created_at":"2026-01-23 12:41:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":55155,"visible":true,"origin":"","legend":"\u003cp\u003eParticipant Flowchart\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7886188/v1/3ccd8a691b7b448b71aedbf0.png"},{"id":101207768,"identity":"a834b494-16a3-41e4-8cc0-1786d3eacb97","added_by":"auto","created_at":"2026-01-27 10:07:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1018835,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7886188/v1/38933324-4765-471c-8e0a-4ec3db960382.pdf"},{"id":100983266,"identity":"28b21ed3-3b69-4ba4-8b35-71fcc2b24ee2","added_by":"auto","created_at":"2026-01-23 12:41:42","extension":"pptx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":146091,"visible":true,"origin":"","legend":"","description":"","filename":"03.Graphicalabstract.pptx","url":"https://assets-eu.researchsquare.com/files/rs-7886188/v1/4e2e3495451b89d29a73725c.pptx"},{"id":101203512,"identity":"a0512640-718d-4f0d-9353-a3702085b5e6","added_by":"auto","created_at":"2026-01-27 09:39:56","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":381590,"visible":true,"origin":"","legend":"","description":"","filename":"05.Questionnaire.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7886188/v1/38c10547aa21f359203a387b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Decadal comparison of Oral Health Literacy among the employees of Udupi taluk postal division, Karnataka state, India – A Cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHealth\u0026nbsp;literacy,\u0026nbsp;as\u0026nbsp;defined\u0026nbsp;by\u0026nbsp;WHO,\u0026nbsp;encompasses\u0026nbsp;the\u0026nbsp;knowledge\u0026nbsp;and\u0026nbsp;skills\u0026nbsp;developed\u0026nbsp;through everyday activities, social interactions, and intergenerational relationships. Organizational structures and resource availability influence these competencies, enabling individuals to access,\u0026nbsp;comprehend,\u0026nbsp;evaluate,\u0026nbsp;and\u0026nbsp;use\u0026nbsp;information\u0026nbsp;and\u0026nbsp;services\u0026nbsp;to promote\u0026nbsp;and\u0026nbsp;maintain\u0026nbsp;their health\u0026nbsp;and\u0026nbsp;well-being\u0026nbsp;\u003csup\u003e(1)\u003c/sup\u003e.\u0026nbsp;It\u0026nbsp;is\u0026nbsp;a\u0026nbsp;compound\u0026nbsp;term\u0026nbsp;used\u0026nbsp;to describe\u0026nbsp;people\u0026apos;s\u0026nbsp;abilities\u0026nbsp;to\u0026nbsp;handle\u0026nbsp;the complex health demands in modern society \u003csup\u003e(2)\u003c/sup\u003e. Oral health literacy refers to the ability of individuals to obtain, process, and understand essential oral health information and services necessary for making informed health decisions \u003csup\u003e(3)\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIndividuals\u0026nbsp;with\u0026nbsp;lower\u0026nbsp;levels\u0026nbsp;of\u0026nbsp;health\u0026nbsp;literacy\u0026nbsp;tend\u0026nbsp;to\u0026nbsp;underutilize\u0026nbsp;preventive\u0026nbsp;screenings,\u0026nbsp;have poorer adherence to medical advice, misuse medications, face higher healthcare costs, experience more frequent hospitalizations, depend more on emergency services, and face an increased\u0026nbsp;risk\u0026nbsp;of\u0026nbsp;mortality\u0026nbsp;\u003csup\u003e(4)\u003c/sup\u003e.\u0026nbsp;Poor\u0026nbsp;oral\u0026nbsp;health\u0026nbsp;arises\u0026nbsp;from\u0026nbsp;multiple\u0026nbsp;factors,\u0026nbsp;including\u0026nbsp;biological characteristics,\u0026nbsp;socioeconomic\u0026nbsp;conditions,\u0026nbsp;nutritional\u0026nbsp;and\u0026nbsp;oral\u0026nbsp;hygiene\u0026nbsp;beliefs\u0026nbsp;and\u0026nbsp;practices,\u0026nbsp;as well\u0026nbsp;as physical\u0026nbsp;and cognitive skills that impact the uptake\u0026nbsp;of\u0026nbsp;preventive practices. Likewise, limited oral health literacy, which involves an individual\u0026rsquo;s motivation and ability to access, understand, and use health information, plays a significant role in poor\u0026nbsp;oral health outcomes\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e(5)\u003c/sup\u003e.\u0026nbsp;Although\u0026nbsp;education is\u0026nbsp;strongly\u0026nbsp;associated with reading skills, educational\u0026nbsp;level\u0026nbsp;by itself\u0026nbsp;is not\u0026nbsp;a\u0026nbsp;sufficient predictor\u0026nbsp;of\u0026nbsp;health literacy. Therefore,\u0026nbsp;we\u0026nbsp;used\u0026nbsp;the\u0026nbsp;Adult Oral\u0026nbsp;Health\u0026nbsp;Literacy (OHL) instrument developed by Sistani et al \u003csup\u003e(6)\u003c/sup\u003e. This instrument incorporates a new set of literacy\u0026nbsp;measures,\u0026nbsp;the\u0026nbsp;Adult-Oral\u0026nbsp;Health\u0026nbsp;Literacy\u0026nbsp;Questionnaire,\u0026nbsp;which\u0026nbsp;includes\u0026nbsp;a\u0026nbsp;dental\u0026nbsp;word recognition component consisting of 17 items.\u003c/p\u003e\n\u003cp\u003eDomestic e-commerce deliveries predominantly rely on the efficiency and reliability of national postal services. Given the essential economic role the postal workers play in facilitating e-commerce and maintaining service standards, it is imperative to thoroughly assess and understand the oral health literacy levels among postal employees across all job designations. Research conducted by Das et al. \u003csup\u003e(7)\u003c/sup\u003e used a bilingually adapted Hindi Oral Health Literacy tool. Among the study participants, 300 (50%) had inadequate oral health literacy, 180 (30%) showed marginal oral health literacy, and only 120 (20%) demonstrated adequate oral health literacy. Females exhibited better oral health literacy compared to males.\u003c/p\u003e\n\u003cp\u003eThere is currently no clear information regarding oral health literacy among postal employees in Udupi Taluk. Therefore, the study sought to evaluate Oral Health Literacy levels among\u003c/p\u003e\n\u003cp\u003epostal employees in Udupi taluk and to compare them across different age groups, genders, and job designations.\u003c/p\u003e\n\u003ch2\u003eAims and objectives\u003c/h2\u003e\n\u003ch2\u003e\u003cstrong\u003eAims\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe\u0026nbsp;study\u0026nbsp;aims\u0026nbsp;to\u0026nbsp;assess\u0026nbsp;the\u0026nbsp;Oral\u0026nbsp;Health\u0026nbsp;Literacy\u0026nbsp;levels\u0026nbsp;among\u0026nbsp;the\u0026nbsp;Postal\u0026nbsp;employees\u0026nbsp;of\u0026nbsp;Udupi taluk, along with a decadal comparison.\u003c/p\u003e\n\u003ch2\u003eObjectives\u003c/h2\u003e\n\u003cul\u003e\n \u003cli\u003eTo\u0026nbsp;determine\u0026nbsp;oral health\u0026nbsp;literacy among\u0026nbsp;different\u0026nbsp;age\u0026nbsp;groups and\u0026nbsp;genders of postal employees.\u003c/li\u003e\n \u003cli\u003eTo determine oral health literacy among different designations of postal employees of Udupi taluk.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eA\u0026nbsp;cross-sectional study, conducted in accordance with the STROBE guidelines and SAGER guidelines, was undertaken between June and December 2024 to assess oral health literacy levels among postal employees in Udupi taluk, Karnataka.\u003c/p\u003e\n\u003cp\u003eThe study received approval from the KMC and KH Institutional Ethics Committee (IEC2: 375/2024) and was registered with the Clinical Trial Registry of India under the number CTRI/2024/08/071869. Prior written informed consent from parents and verbal assent were obtained from the participants. \u003cstrong\u003eThe study was conducted in accordance with ethical principles of the Declaration of Helsinki in relation to Ethics approval and consent to participate.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eInclusion criteria:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were postal\u0026nbsp;employees between\u0026nbsp;25 and 60 years of\u0026nbsp;age, employed in\u0026nbsp;post offices in Udupi taluk, Karnataka, and willing to give informed consent for the study.\u003c/p\u003e\n\u003cp\u003eThe Post offices included in the study were:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Udupi,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;India Post,\u0026nbsp;Manipal,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Krodashrama,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Kunjibettu,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Malpe,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office, Santhekatte, and\u003c/li\u003e\n \u003cli\u003ePostmaster of Sub Post Office, Ambalpadi\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cem\u003eExclusion criteria:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants unwilling to participate or unable to give informed consent were not included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStudy proforma:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants\u0026rsquo; demographic details were collected in the first section of the self-administered questionnaire.\u003c/p\u003e\n\u003cp\u003eThe second section assessed oral health practices, including the frequency of tooth brushing, types of oral hygiene aids used, frequency of toothbrush replacement, use of a tongue cleaner, dental floss usage, and habits related to smoking and alcohol consumption.\u003c/p\u003e\n\u003cp\u003eThe third section comprised items designed to measure participants\u0026rsquo; oral health literacy.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSample size:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOne hundred ninety-seven employees were working under the various post offices, subunits, and\u0026nbsp;post\u0026nbsp;collection\u0026nbsp;units\u0026nbsp;under\u0026nbsp;Udupi\u0026nbsp;taluk.\u0026nbsp;The\u0026nbsp;statistician\u0026rsquo;s\u0026nbsp;inputs\u0026nbsp;have\u0026nbsp;been\u0026nbsp;duly\u0026nbsp;taken,\u0026nbsp;and the\u0026nbsp;statistician\u0026nbsp;believes\u0026nbsp;that a\u0026nbsp;complete\u0026nbsp;enumeration\u0026nbsp;of\u0026nbsp;all\u0026nbsp;the\u0026nbsp;postal\u0026nbsp;employees\u0026nbsp;in\u0026nbsp;Udupi\u0026nbsp;taluk will be appropriate.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Analysis:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive analysis was conducted using SPSS software version 23.0 (SPSS Inc., Chicago, IL, USA). A p-value of \u0026le;0.05 was considered statistically significant. The descriptive data for the sample population were calculated as frequencies and percentages. The association between Oral Health Literacy and all the variables was analyzed using the independent t-test and one-way ANOVA.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 131 participants (Figure 1) were analysed out of 197 participants. 69 participants declined to participate in the study.\u003c/p\u003e\n\u003cp\u003eAdults\u0026nbsp;aged\u0026nbsp;25\u0026nbsp;-\u0026nbsp;60\u0026nbsp;years\u0026nbsp;of\u0026nbsp;age,\u0026nbsp;with\u0026nbsp;a\u0026nbsp;mean\u0026nbsp;age\u0026nbsp;of\u0026nbsp;43.07\u0026nbsp;\u0026plusmn;\u0026nbsp;9.49\u0026nbsp;years,\u0026nbsp;and\u0026nbsp;oral\u0026nbsp;health\u0026nbsp;literacy was found to be moderate, with a mean score of 10.9 \u0026plusmn; 2.03.\u003c/p\u003e\n\u003cp\u003eThe study reported a participation rate of 60.3% among male subjects and 39.7% among female subjects, indicating a dominant presence of male participants in the research. 50.4% were postmen/postwomen, 23.7% were central government employees, 18.3% were postal assistants, 5.3% were postal security workers, and 2.3% were postal clerks. Among the participants, 88.5% were married, while 11.5% were unmarried. \u003cstrong\u003e(Table 1)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 : Distribution of study participants according to demographic characteristics\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e21-30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e31-40 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e35.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e41-50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eAbove\u0026nbsp;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e39.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostal assistant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eCentral Government\u003c/p\u003e\n \u003cp\u003eEmployee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e23.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostman/Post\u0026nbsp;woman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e50.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostal Clerk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostal Security\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eHighschool/ Diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e53.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eGraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e42.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e88.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003en = number of participants\u003c/p\u003e\n\u003cp\u003eIn the study population, 42.7% brushed their teeth 2\u0026ndash;3 times daily, whereas the majority, 57.3% brushed only once a day. Furthermore, an impressive 97.7% use a toothbrush with toothpaste, only 2.3% choose chewsticks, neem leaves, or neem chewsticks, and 70.2% change their toothbrush every three months. \u003cstrong\u003e(Table 2)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 : Oral health practices among the study participants\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 397px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHow\u0026nbsp;often\u0026nbsp;do\u0026nbsp;you\u0026nbsp;brush your teeth?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e2-3\u0026nbsp;times\u0026nbsp;a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e42.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eOnce\u0026nbsp;a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e57.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eWhat do you use to clean your teeth?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eChewsticks/neem\u003c/p\u003e\n \u003cp\u003eleaves/neem chewstick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eToothbrush\u0026nbsp;with toothpaste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHow often do you change your toothbrush?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eEvery\u0026nbsp;3\u0026nbsp;months once\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e70.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eEvery\u0026nbsp;6\u0026nbsp;months once\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eWhen\u0026nbsp;the\u0026nbsp;brush\u0026nbsp;bristles fall\u003c/p\u003e\n \u003cp\u003eoff\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHow\u0026nbsp;often\u0026nbsp;do\u0026nbsp;you\u0026nbsp;use\u0026nbsp;a tongue cleaner?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eOnce\u0026nbsp;a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e58.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e2\u0026nbsp;times\u0026nbsp;a\u0026nbsp;day\u0026nbsp;(every\u0026nbsp;time after\u003c/p\u003e\n \u003cp\u003ebrushing)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003ed. 2-3\u0026nbsp;times\u0026nbsp;a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you use dental\u0026nbsp;floss in your daily life?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e90.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny\u0026nbsp;habit\u0026nbsp;of\u0026nbsp;smoking\u0026nbsp;/ smokeless tobacco?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;habit of drinking Alcohol?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e99.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003en=number of participants\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere was no significant variation in OHL across different age groups (p \u0026gt; 0.05). The highest OHL was reported in the 21-30 decade group (11.8 \u0026plusmn; 1.81), while the lowest was in the 41-50 decade group (10.4 \u0026plusmn; 2.30). A statistically significant difference exists among gender (p \u0026lt; 0.05), with Females (11.4 \u0026plusmn; 1.77) having a higher OHL score compared to males (10.5 \u0026plusmn; 2.11). Employees of the Central Government had a higher mean score for OHL (11.6 \u0026plusmn; 2.01) compared to other designations among the study participants. \u003cstrong\u003e(Table 3)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 : Oral health literacy ( Mean \u003cu\u003e+\u003c/u\u003e SD ) in comparison with demographic characteristics :\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOHL\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u0026nbsp;\u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eBelow\u0026nbsp;35 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.40\u0026nbsp;\u0026plusmn; 1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e36-43 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.7\u0026nbsp;\u0026plusmn; 2.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e44-51 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.4\u0026nbsp;\u0026plusmn; 2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eAbove\u0026nbsp;51 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.0\u0026nbsp;\u0026plusmn; 1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.5\u0026nbsp;\u0026plusmn; 2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.006*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.4\u0026nbsp;\u0026plusmn; 1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostal assistant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.2\u0026nbsp;\u0026plusmn; 2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eCentral Government\u003c/p\u003e\n \u003cp\u003eEmployee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.6\u0026nbsp;\u0026plusmn; 2.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostman/Post\u0026nbsp;woman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.4\u0026nbsp;\u0026plusmn; 2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostal Clerk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.0\u0026nbsp;\u0026plusmn; 1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePostal Security\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.8\u0026nbsp;\u0026plusmn; 0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.0\u0026nbsp;\u0026plusmn; 1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.965\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eHighschool/ Diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.8\u0026nbsp;\u0026plusmn; 2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eGraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.0\u0026nbsp;\u0026plusmn; 1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.0\u0026nbsp;\u0026plusmn; 2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.959\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.8\u0026nbsp;\u0026plusmn; 2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eIndependent t-test\u003c/p\u003e\n\u003cp\u003eOne-way ANOVA\u003c/p\u003e\n\u003cp\u003e*P \u0026lt;0.05 was considered significant\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e Our study explores evolving trends in Oral Health Literacy among postal employees in Udupi Taluk. Results revealed that 22.1% of female participants had higher OHL, which is similar to a study by Sfeatcu \u003csup\u003e(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/sup\u003e, indicating that women generally exhibit positive attitudes, place a higher value on oral health, practice better oral hygiene behaviours, and possess greater oral health literacy than men. Another study conducted by Lipsky \u003csup\u003e(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/sup\u003e revealed that women tend to have more favorable attitudes towards dental visits, higher oral health literacy, and engage in better oral health practices. In our study, 97.7% of participants reported that they brush their teeth using a toothbrush and toothpaste. This finding contrasts with a study conducted by Selvaraj \u003csup\u003e(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/sup\u003e, which indicated that 18.4% of respondents believed keeping teeth clean and healthy has a positive effect on health, and 92% perceived scaling as harmful to their gums.\u003c/p\u003e \u003cp\u003eOur findings found only 13.0% of participants aged over 50 demonstrated higher Oral Health Literacy, which aligns with the study conducted by Piyakhunakorn \u003csup\u003e(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/sup\u003e, which indicated that older individuals tend to have lower education levels. Furthermore, brushing teeth less than twice daily was a statistically significant predictor of lower oral health literacy (OHL) among participants.\u003c/p\u003e \u003cp\u003eOur study findings also revealed that 14.5% of central government employees had higher OHL, which is compared to a study by Carrouel \u003csup\u003e(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/sup\u003e, indicating some public officials in France possessed marginal levels of oral health knowledge and Literacy. Although significant progress has been made in Health Literacy, particularly among employees with minimal education and older age cohorts, they continue to exhibit lower levels of understanding and engagement with oral health concepts. These disparities can often be attributed to several factors, including insufficient access to comprehensive health education programs and the persistence of long- standing habits that resist modification. For example, those with minimal formal education could have restricted access to information on oral health, which can limit their capacity to make informed oral health decisions. Similarly, older adults may have developed entrenched practices that are not easily altered, even in the face of new, evidence-based recommendations regarding oral hygiene and health. Addressing these issues requires targeted educational initiatives and tailored interventions that consider the unique needs and challenges of these groups.\u003c/p\u003e \u003cp\u003e By examining the effectiveness of workplace oral health promotion programs, we can identify actionable strategies for improving oral health literacy and help in assessing whether there have\u003c/p\u003e \u003cp\u003ebeen significant shifts in oral hygiene habits, dietary choices, and health-seeking behaviors among postal employees.\u003c/p\u003e \u003cp\u003eLimitations of this study include participants often failing to accurately recall their past behaviors or changes in their oral health practices, which leads to significant inaccuracies in self-reported data and creates a clear risk of response bias and social desirability bias. It is essential to tailor oral health literacy programs to specific employee demographics, particularly those with lower educational backgrounds, to effectively close the existing gaps. Employers and policymakers must prioritize the integration of oral health education and preventive dental check-ups into employee wellness programs to promote better overall health outcomes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings show a shift in knowledge toward oral health among postal employees, likely influenced by better access to healthcare information, public health initiatives, and workplace health programs.\u003c/p\u003e \u003cp\u003eDespite improvements in oral health literacy, disparities may persist due to factors like age, educational background, and access to health promotion activities.\u003c/p\u003e \u003cp\u003eThis research emphasizes the value of implementing tailored oral health education programs for employees, which may substantially improve oral health outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval:\u0026nbsp;\u003c/strong\u003eEthical approval obtained from Kasturba Medical College and Kasturba Hospitals, Institutional Ethics Committee \u0026ndash; 2 (IEC2: 375/2024)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCTRI registration number:\u0026nbsp;\u003c/strong\u003eCTRI/2024/08/071869\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate:\u0026nbsp;\u003c/strong\u003eInformed consent was taken prior to data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eNot applicable\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability\u0026nbsp;of\u0026nbsp;data\u0026nbsp;and\u0026nbsp;material\u0026nbsp;(data\u0026nbsp;transparency):\u0026nbsp;\u003c/strong\u003eData is available for sharing on appropriate request to the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest/Competing interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no conflicts of interest/competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eSelf\u0026ndash;funded\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthorship contribution statement:\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eDr PVA \u0026ndash; Principal student\u0026nbsp;researcher,\u0026nbsp;data collection,\u0026nbsp;data analysis,\u0026nbsp;interpretation, manuscript writing\u003c/li\u003e\n \u003cli\u003eDr RVP \u0026ndash; Principal investigator, conceptualization of study, intellectual inputs, study co-ordination, manuscript review\u003c/li\u003e\n \u003cli\u003eDr MAK \u0026ndash; Sample size estimation, study design, data analysis, statistical tables and reporting\u003c/li\u003e\n \u003cli\u003eDr\u0026nbsp;PPN\u0026nbsp;\u0026ndash;\u0026nbsp;Study\u0026nbsp;design,\u0026nbsp;data\u0026nbsp;analysis\u0026nbsp;and\u0026nbsp;interpretation,\u0026nbsp;manuscript\u0026nbsp;review\u0026nbsp;and\u0026nbsp;editing\u003c/li\u003e\n \u003cli\u003eDr\u0026nbsp;JP\u0026nbsp;\u0026ndash;\u0026nbsp;Data\u0026nbsp;collection\u0026nbsp;and\u0026nbsp;field\u0026nbsp;visit\u0026nbsp;support,\u0026nbsp;literature\u0026nbsp;compilation\u003c/li\u003e\n \u003cli\u003eDr AP \u0026ndash; Study design, manuscript review, study implementation support\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eSincere\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Udupi,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;India Post,\u0026nbsp;Manipal,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Krodashrama,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Kunjibettu,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Malpe,\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Head\u0026nbsp;Post\u0026nbsp;Office, Santhekatte, and\u003c/li\u003e\n \u003cli\u003ePostmaster\u0026nbsp;of\u0026nbsp;Sub\u0026nbsp;Post\u0026nbsp;Office,\u0026nbsp;Ambalpadi\u003c/li\u003e\n \u003cli\u003eHealth\u0026nbsp;Sciences\u0026nbsp;Library,\u0026nbsp;Manipal\u0026nbsp;Academy\u0026nbsp;of\u0026nbsp;Higher\u0026nbsp;Education,\u0026nbsp;Manipal\u003c/li\u003e\n \u003cli\u003eAll the postal employee participants of the study\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eS\u0026oslash;rensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012 Dec 25;12(1):80.\u003c/li\u003e\n \u003cli\u003eS\u0026oslash;rensen K, Van Den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: Illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13(1).\u003c/li\u003e\n \u003cli\u003eKing\u0026nbsp;S,\u0026nbsp;Thaliph\u0026nbsp;A,\u0026nbsp;Laranjo\u0026nbsp;L,\u0026nbsp;Smith\u0026nbsp;BJ,\u0026nbsp;Eberhard\u0026nbsp;J.\u0026nbsp;Oral\u0026nbsp;health\u0026nbsp;literacy,\u0026nbsp;knowledge\u0026nbsp;and perceptions\u0026nbsp;in\u0026nbsp;a\u0026nbsp;socially\u0026nbsp;and\u0026nbsp;culturally\u0026nbsp;diverse\u0026nbsp;population:\u0026nbsp;a\u0026nbsp;mixed\u0026nbsp;methods\u0026nbsp;study.\u0026nbsp;BMC Public Health. 2023 Dec 1;23(1).\u003c/li\u003e\n \u003cli\u003eLee CJ, Ho MH, Joo JY, Montayre J, Lin\u0026nbsp;YK, Chang CC, et al. Gender differences in the\u0026nbsp;association\u0026nbsp;between\u0026nbsp;oral\u0026nbsp;health\u0026nbsp;literacy\u0026nbsp;and\u0026nbsp;oral\u0026nbsp;health-related\u0026nbsp;quality\u0026nbsp;of\u0026nbsp;life\u0026nbsp;in\u0026nbsp;older adults. BMC Oral Health. 2022 Dec 1;22(1).\u003c/li\u003e\n \u003cli\u003eThapa\u0026nbsp;SB,\u0026nbsp;Dramani\u0026nbsp;Kipo-Sunyehzi\u0026nbsp;D.\u0026nbsp;Interplay\u0026nbsp;of\u0026nbsp;health\u0026nbsp;literacy,\u0026nbsp;healthcare\u0026nbsp;access\u0026nbsp;and health behaviors with oral health status among older persons.\u003c/li\u003e\n \u003cli\u003eNaghibi Sistani MM, Montazeri\u0026nbsp;A, Yazdani R, Murtomaa H. New oral health literacy instrument for public health: development and pilot testing. J Investig Clin Dent. 2014 Nov 1;5(4):313\u0026ndash;21.\u003c/li\u003e\n \u003cli\u003eDas\u0026nbsp;D, Menon\u0026nbsp;I, Gupta R,\u0026nbsp;Arora\u0026nbsp;V,\u0026nbsp;Ashraf\u0026nbsp;A,\u0026nbsp;Ahsan\u0026nbsp;I. Oral\u0026nbsp;health literacy:\u0026nbsp;A\u0026nbsp;practical strategy\u0026nbsp;towards better\u0026nbsp;oral\u0026nbsp;health status among adult population of\u0026nbsp;Ghaziabad district. J Family Med Prim Care. 2020;9(2):764.\u003c/li\u003e\n \u003cli\u003eSfeatcu\u0026nbsp;R,\u0026nbsp;Balgiu\u0026nbsp;BA,\u0026nbsp;Mihai\u0026nbsp;C,\u0026nbsp;Petre\u0026nbsp;A,\u0026nbsp;Pantea\u0026nbsp;M,\u0026nbsp;Tribus\u0026nbsp;L.\u0026nbsp;Gender\u0026nbsp;Differences\u0026nbsp;in\u0026nbsp;Oral Health: Self-Reported Attitudes, Values, Behaviours and Literacy among Romanian Adults. J Pers Med. 2022 Oct 1;12(10).\u003c/li\u003e\n \u003cli\u003eLipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Vol. 15, American Journal of Men\u0026rsquo;s Health. SAGE Publications Inc.; 2021.\u003c/li\u003e\n \u003cli\u003eSelvaraj S, Naing NN, Wan-Arfah N, De Abreu MHNG. Assessment on Oral Health Knowledge, Attitude, and Behaviour and its Association with Sociodemographic and Habitual Factors of South Indian Population. Pesqui Bras Odontopediatria Clin Integr. 2021 Oct 22;21.\u003c/li\u003e\n \u003cli\u003ePiyakhunakorn P, Sermsuti-anuwat N. The\u0026nbsp;Associations between Oral Health Literacy and Oral Health-Related Behaviours among Community-Dwelling Older People in Thailand. Glob J Health Sci. 2021 Jan 8;13(3):1.\u003c/li\u003e\n \u003cli\u003eCarrouel F, du Sartz de Vigneulles B, Cl\u0026eacute;ment C, Lvovschi VE, Verot E, Tantardini V, et al. Promoting Health Literacy in the Workplace Among Civil Servants: Cross- Sectional Study. JMIR Public Health Surveill. 2024;10.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Oral health literacy, Postal service, Attitudes, Cross-sectional study","lastPublishedDoi":"10.21203/rs.3.rs-7886188/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7886188/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eOral health literacy (OHL) is an important factor that affects oral health outcomes. Postal employees display distinct patterns of oral health literacy due to their work routine and exposure. Monitoring changes in oral health literacy can help develop targeted interventions. The study aimed to compare oral health literacy among postal employees of Udupi taluk.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted among postal employees in Udupi Taluk using a standardized questionnaire to assess oral health literacy. Socio- demographic variables and self-reported oral health behaviors were also recorded, followed by statistical analysis to identify trends and correlations.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe findings indicate no significant variation in OHL across different decades (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The highest OHL is observed in the 21\u0026ndash;30 decade group (11.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.81), while the lowest is in the 41\u0026ndash;50 decade group (10.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.30).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe results suggest increased oral health awareness due to improved access to healthcare information and public health initiatives.\u003c/p\u003e","manuscriptTitle":"Decadal comparison of Oral Health Literacy among the employees of Udupi taluk postal division, Karnataka state, India – A Cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-23 12:41:32","doi":"10.21203/rs.3.rs-7886188/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-01-28T12:39:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-26T03:03:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-23T07:25:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"199192951367334740134941818445952074344","date":"2026-01-23T06:06:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-23T02:16:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"171678317510823793962565734004520048779","date":"2026-01-23T02:05:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"63773463972378090251300313595358614048","date":"2026-01-21T15:50:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282243106826069638193761601779108307184","date":"2026-01-21T13:50:16+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-21T09:14:12+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-30T11:16:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-26T16:57:13+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-26T05:25:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-11-26T05:18:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b49a8eea-d1c6-4b13-81c8-67a6e6cec648","owner":[],"postedDate":"January 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-23T12:41:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-23 12:41:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7886188","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7886188","identity":"rs-7886188","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}