# Maternal food literacy and health behaviors in relation to children’s DMFT scores: a cross-sectional study from Türkiye

## TL;DR

This study from Türkiye found that maternal health literacy, not food literacy, is linked to higher dental caries in children, along with poor oral hygiene and socioeconomic factors.

## Contribution

The study is the first to explore maternal food literacy's role in children's oral health in a low- to middle-income setting.

## Key findings

- Higher maternal health literacy was independently associated with increased caries experience in children.
- Socioeconomic factors and poor oral hygiene behaviors were strongly linked to higher DMFT scores in children.
- A modest but significant correlation was found between maternal and child DMFT scores.

## Abstract

Oral health in childhood is influenced by parental literacy, dietary practices, and hygiene behaviors. Maternal food literacy may play a critical role in shaping children’s oral health, yet this relationship remains underexplored in low- and middle-income settings. This study aimed to investigate the association between maternal food literacy and the oral health status of their children, focusing on dental caries experience (DMFT scores), oral hygiene behaviors, and sociodemographic factors.

A cross-sectional study was conducted in Dörtyol, Hatay (June 2022 – February 2023) involving 113 children aged 40–120 months and their mothers. Data were collected using validated Maternal Food Literacy and Maternal Health Literacy questionnaires, alongside structured questionnaires on children's oral health behaviors, while clinical oral examinations were performed to calculate DMFT (Decayed, Missing, Filled Teeth) scores. Statistical analyses included Spearman correlation, non-parametric tests, and multiple linear regression analysis using the backward elimination method, with p < 0.05 considered statistically significant.

The mean DMFT scores were 8.1 (±3.9) in children and 6.9 (±4.0) in mothers. While there was no significant relationship between the mother's food literacy and the child's DMFT scores (p=0.748), the mother's high health literacy was found to be associated with the child's high DMFT scores (B(95%CI) = 0.04 (0.01 – 0.08), p=0.025). Maternal education (p=0.019), employment status (p=0.003), and socioeconomic level (p=0.028) were significantly associated with DMFT. Behavioral factors—such as lack of personal toothbrush (p=0.018), low brushing frequency (p=0.002), and absence of fluoride varnish (p=0.008)—were also linked to higher caries levels. A modest but significant positive correlation was observed between maternal and child DMFT scores (r=0.264, p<0.01).

Although maternal food literacy was not directly associated with children’s DMFT scores in bivariate analyses, the multiple linear regression model using the backward elimination method identified higher maternal health literacy as an independent predictor of increased caries experience in children. Socioeconomic conditions and oral health behaviors were also strongly associated with caries outcomes. These findings emphasize the importance of daily oral hygiene habits in children and suggest that oral health interventions should address behavioral education within families, regardless of literacy level.