# Building Oral Health Literacy in Adolescence: A Qualitative Exploration of Knowledge and Behaviours in Spain

## TL;DR

This study explores oral health knowledge and behaviors among adolescents in a low-income, immigrant-rich area of Spain to inform better health promotion strategies.

## Contribution

The study provides insights into how socioeconomic and cultural factors shape adolescent oral health behaviors and suggests asset-based approaches for health promotion.

## Key findings

- Adolescents had moderate oral health literacy with gaps in understanding systemic consequences of poor oral health.
- Social, economic, and normative factors strongly influenced oral health behaviors.
- Parental involvement and school-based initiatives were identified as key assets for promoting oral health.

## Abstract

Background: Oral health during adolescence is a key determinant of long-term well-being and health equity. Despite widespread recognition of its importance, disparities in knowledge, motivation, and access to care persist. This study was conducted in Salt (Catalonia, Spain), a municipality with a population of approximately 33,000, characterized by a low average household disposable income (€12,512 per capita) and a high proportion of immigrant residents (37.76%). These sociodemographic characteristics may influence adolescents’ oral health behaviour, perceptions, and access to dental care. The study aimed to explore adolescents’ knowledge, habits, and attitudes towards oral health in this context, with barriers and protective factors, to inform community-based health promotion strategies. Methods: A qualitative descriptive study was conducted using focus group discussions with Spanish adolescents aged between 12 and 16, following ethical approval and informed consent from legal guardians. Data were systematically analysed using thematic analysis. Results: The adolescents had moderate oral health literacy, with basic knowledge of dental caries and prevention, but notable gaps in their knowledge regarding systemic consequences and complementary resources. Oral health behaviours and practices were shaped by social, economic, and normative influences, while parental involvement, community support, and school-based initiatives emerged as key assets for the promotion of oral health. Conclusions: While adolescents in Salt show awareness of oral hygiene, structural, motivational, and informational barriers limit comprehensive oral health practices. Interventions should move beyond knowledge-based education towards culturally adapted, participatory, and asset-based approaches to promote sustainable improvements in adolescent oral health.