{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T01:03:20Z","timestamp":1784855000203,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":66,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral health literacy is the capacity of processing and understanding basic oral health information. Instruments are available for its measurement in English and other languages. But no validated tool is available in Nepali language that could be used to assess oral health literacy level of Nepalese population. The objective of this study was to translate and validate the Nepalese version of Oral Health Literacy Instrument (OHLI-N) from the original English version.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The English version of OHLI along with oral health knowledge test was translated into Nepali language. The translated version was reviewed and pretested on conveniently selected 30 participants. A cross-sectional study was conducted among conveniently selected 160 adult patients of 18 years and above visiting dental OPD of a tertiary care center for testing validity and reliability of OHLI-N. Oral examination was done to record DMFT and CPI scores. Concurrent validity, construct validity and predictive validity of OHLI-N was determined. Internal consistency of OHLI-N was evaluated using Cronbach\u2019s alpha (\u03b1). OHLI-N was readministered in 25 patients after 2 weeks to assess test-retest reliability using intra-class correlation coefficient (ICC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean overall OHLI-N score of the participants was 65.9\u2009\u00b1\u200917.6. OHLI-N scores were significantly associated with educational level of participants (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A significant positive correlation (r\n                      <jats:sub>s<\/jats:sub>\n                      =0.72) was observed between OHLI-N and oral health knowledge test. Moderate and statistically significant negative correlation was seen between OHLI-N and oral outcomes including DMFT score (r\n                      <jats:sub>s<\/jats:sub>\n                      = -0.49), number of untreated caries (r\n                      <jats:sub>s<\/jats:sub>\n                      = -0.48), number of teeth with bleeding on probing (r\n                      <jats:sub>s<\/jats:sub>\n                      = -0.71) and number of teeth with periodontal pocket (r\n                      <jats:sub>s<\/jats:sub>\n                      = -0.49). OHLI-N showed high internal consistency (\u03b1\u2009=\u20090.92) and test-retest reliability (ICC\u2009=\u20090.99).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The OHLI-N showed good validity and reliability for assessing the oral health literacy level of adult patients visiting a tertiary care center of Nepal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08632-9","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:56:02Z","timestamp":1779188162000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of oral health literacy instrument in Nepali language: a tool to assess oral health literacy of Nepalese population"],"prefix":"10.1186","volume":"26","author":[{"given":"Tarakant","family":"Bhagat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh Kumari","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binita","family":"Limbu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"issue":"10194","key":"8632_CR1","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","volume":"394","author":"MA Peres","year":"2019","unstructured":"Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249\u201360.","journal-title":"Lancet"},{"issue":"1","key":"8632_CR2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1146\/annurev-publhealth-090419-102529","volume":"42","author":"D Nutbeam","year":"2021","unstructured":"Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021;42(1):159\u201373.","journal-title":"Annu Rev Public Health"},{"key":"8632_CR3","volume-title":"Health literacy. National library of medicine current bibliographies in medicine","author":"CR Selden","year":"2000","unstructured":"Selden CR, Zorn M, Ratzan S, Parker RM. Health literacy. National library of medicine current bibliographies in medicine. Bethesda: National Institutes of Health, US Department of Health and Human Services; 2000."},{"key":"8632_CR4","volume-title":"Health literacy: a prescription to end confusion","year":"2004","unstructured":"Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health literacy: a prescription to end confusion. Washington D.C: National Academies; 2004."},{"issue":"1","key":"8632_CR5","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/1472-6831-14-148","volume":"14","author":"V Dickson-Swift","year":"2014","unstructured":"Dickson-Swift V, Kenny A, Farmer J, Gussy M, Larkins S. Measuring oral health literacy: a scoping review of existing tools. BMC Oral Health. 2014;14(1):148.","journal-title":"BMC Oral Health"},{"key":"8632_CR6","unstructured":"Isman B. Healthy People 2010: Oral Health Toolkit. Available from: https:\/\/stacks.cdc.gov\/view\/cdc\/11474\/cdc_11474_DS1.pdf. Accessed on: 2 Aug. 2023."},{"issue":"1","key":"8632_CR7","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/j.1752-7325.2012.00375.x","volume":"74","author":"MMH Wehmeyer","year":"2014","unstructured":"Wehmeyer MMH, Corwin CL, Guthmiller JM, Lee JY. The impact of oral health literacy on periodontal health status. J Public Health Dent. 2014;74(1):80\u20137.","journal-title":"J Public Health Dent"},{"issue":"1","key":"8632_CR8","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1902\/jop.2016.160203","volume":"88","author":"JS Holtzman","year":"2017","unstructured":"Holtzman JS, Atchison KA, Macek MD, Markovic D. Oral health literacy and measures of periodontal disease. J Periodontol. 2017;88(1):78\u201388.","journal-title":"J Periodontol"},{"issue":"1","key":"8632_CR9","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12903-018-0640-1","volume":"18","author":"JK Baskaradoss","year":"2018","unstructured":"Baskaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health. 2018;18(1):172.","journal-title":"BMC Oral Health"},{"issue":"1","key":"8632_CR10","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s12889-017-4443-0","volume":"18","author":"MJ Batista","year":"2018","unstructured":"Batista MJ, Lawrence HP, Sousa MDLRD. Oral health literacy and oral health outcomes in an adult population in Brazil. BMC Public Health. 2018;18(1):60.","journal-title":"BMC Public Health"},{"issue":"5","key":"8632_CR11","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/j.1600-0528.2009.00490.x","volume":"37","author":"DA Sabbahi","year":"2009","unstructured":"Sabbahi DA, Lawrence HP, Limeback H, Rootman I. Development and evaluation of an oral health literacy instrument for adults. Commun Dent Oral Epidemiol. 2009;37(5):451\u201362.","journal-title":"Commun Dent Oral Epidemiol"},{"issue":"5","key":"8632_CR12","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1016\/j.identj.2021.12.004","volume":"72","author":"FMR Bado","year":"2022","unstructured":"Bado FMR, Barbosa TDS, Soares GH, Mialhe FL. Oral health literacy and periodontal disease in primary health care users. Int Dent J. 2022;72(5):654\u20138.","journal-title":"Int Dent J"},{"key":"8632_CR13","doi-asserted-by":"publisher","first-page":"S26","DOI":"10.1111\/j.1752-7325.2012.00316.x","volume":"72","author":"AM Horowitz","year":"2012","unstructured":"Horowitz AM, Kleinman DV. Oral health literacy: a pathway to reducing oral health disparities in Maryland. J Public Health Dent. 2012;72:S26\u201330.","journal-title":"J Public Health Dent"},{"issue":"1","key":"8632_CR14","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1186\/1471-2458-14-1207","volume":"14","author":"SV Altin","year":"2014","unstructured":"Altin SV, Finke I, Kautz-Freimuth S, Stock S. The evolution of health literacy assessment tools: a systematic review. BMC Public Health. 2014;14(1):1207.","journal-title":"BMC Public Health"},{"issue":"1","key":"8632_CR15","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s12903-020-01170-y","volume":"20","author":"M Ghaffari","year":"2020","unstructured":"Ghaffari M, Rakhshanderou S, Ramezankhani A, Mehrabi Y, Safari-Moradabadi A. Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties. BMC Oral Health. 2020;20(1):186.","journal-title":"BMC Oral Health"},{"issue":"1","key":"8632_CR16","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/1472-6831-14-141","volume":"14","author":"A Blizniuk","year":"2014","unstructured":"Blizniuk A, Ueno M, Furukawa S, Kawaguchi Y. Evaluation of a Russian version of the oral health literacy instrument (OHLI). BMC Oral Health. 2014;14(1):141.","journal-title":"BMC Oral Health"},{"issue":"4","key":"8632_CR17","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1111\/idj.12288","volume":"67","author":"RA Cartes-Vel\u00e1squez","year":"2017","unstructured":"Cartes-Vel\u00e1squez RA, Luengo Machuca L. Adaptation and validation of the oral health literacy instrument for the Chilean population. Int Dent J. 2017;67(4):215\u201320.","journal-title":"Int Dent J"},{"issue":"15","key":"8632_CR18","doi-asserted-by":"publisher","first-page":"5407","DOI":"10.3390\/ijerph17155407","volume":"17","author":"MZ Ramlay","year":"2020","unstructured":"Ramlay MZ, Saddki N, Tin-Oo MM, Arifin WN. Cross-cultural adaptation and validation of Oral Health Literacy Instrument (OHLI) for Malaysian adults. Int J Environ Res Public Health. 2020;17(15):5407.","journal-title":"Int J Environ Res Public Health"},{"issue":"24","key":"8632_CR19","doi-asserted-by":"publisher","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","volume":"25","author":"DE Beaton","year":"2000","unstructured":"Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186\u201391.","journal-title":"Spine"},{"key":"8632_CR20","unstructured":"Petersen PE, Baez RJ, World Health Organization. Oral health surveys: basic methods. 5th edition.Geneva: World Health Org. 2013; Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/97035."},{"issue":"2","key":"8632_CR21","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.cden.2007.12.001","volume":"52","author":"AM Horowitz","year":"2008","unstructured":"Horowitz AM, Kleinman DV. Oral health literacy: The new imperative to better oral health. Dental Clin N Am. 2008;52(2):333\u201344.","journal-title":"Dental Clin N Am"},{"key":"8632_CR22","unstructured":"American Dental Association. Health Literacy in Dentistry. Available from: https:\/\/www.ada.org\/resources\/community-initiatives\/health-literacy-in-dentistry Accessed on 28 Dec. 2023."},{"issue":"2","key":"8632_CR23","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1111\/j.1752-7325.2007.00021.x","volume":"67","author":"JY Lee","year":"2007","unstructured":"Lee JY, Rozier RG, Lee SYD, Bender D, Ruiz RE. Development of a word recognition instrument to test health literacy in dentistry: The REALD-30- A Brief Communication. J Public Health Dent. 2007;67(2):94\u20138.","journal-title":"J Public Health Dent"},{"issue":"2","key":"8632_CR24","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1111\/j.1752-7325.2007.00023.x","volume":"67","author":"DA Gong","year":"2007","unstructured":"Gong DA, Lee JY, Rozier RG, Pahel BT, Richman JA, Vann WF. Development and testing of the Test of Functional Health Literacy in Dentistry (TOFHLiD). J Public Health Dent. 2007;67(2):105\u201312.","journal-title":"J Public Health Dent"},{"key":"8632_CR25","doi-asserted-by":"crossref","unstructured":"Fazli M, Yazdani R, Mohebbi SZ, Shamshiri AR. Oral Health Literacy and Its Determinants in Young Couples. Front Dentistry. 2023;20:27.","DOI":"10.18502\/fid.v20i27.13345"},{"issue":"8","key":"8632_CR26","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.3390\/ijerph15081748","volume":"15","author":"E Henderson","year":"2018","unstructured":"Henderson E, Dalawari P, Fitzgerald J, Hinyard L. Association of oral health literacy and dental visitation in an inner-city emergency department population. Int J Environ Res Public Health. 2018;15(8):1748.","journal-title":"Int J Environ Res Public Health"},{"key":"8632_CR27","doi-asserted-by":"publisher","first-page":"e0122","DOI":"10.1590\/1807-3107bor-2022.vol36.0122","volume":"36","author":"LRDS Assun\u00e7\u00e3o","year":"2022","unstructured":"Assun\u00e7\u00e3o LRDS, Fagundes FAU, Kuklik HH, Ferreira FDM, Fraiz FC. Different dimensions of oral health literacy are associated with social determinants of health in Brazilian adults. Brazilian Oral Res. 2022;36:e0122.","journal-title":"Brazilian Oral Res"},{"issue":"02","key":"8632_CR28","doi-asserted-by":"publisher","first-page":"162","DOI":"10.4103\/ejd.ejd_332_16","volume":"11","author":"MMN Sistani","year":"2017","unstructured":"Sistani MMN, Virtanen J, Yazdani R, Murtomaa H. Association of oral health behavior and the use of dental services with oral health literacy among adults in Tehran, Iran. Eur J Dentistry. 2017;11(02):162\u20137.","journal-title":"Eur J Dentistry"},{"issue":"8","key":"8632_CR29","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1111\/j.1525-1497.2006.00540.x","volume":"21","author":"DW Baker","year":"2006","unstructured":"Baker DW. The meaning and the measure of health literacy. J Gen Intern Med. 2006;21(8):878\u201383.","journal-title":"J Gen Intern Med"},{"key":"8632_CR30","first-page":"293","volume":"2","author":"N Kaur","year":"2015","unstructured":"Kaur N, Kandelman D, Nimmon L, Potvin L. Oral health literacy: Findings of a scoping review. EC Dent Sci. 2015;2:293\u2013306.","journal-title":"EC Dent Sci"},{"issue":"3","key":"8632_CR31","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1111\/j.1752-7325.2010.00165.x","volume":"70","author":"MD Macek","year":"2010","unstructured":"Macek MD, Haynes D, Wells W, Bauer-Leffler S, Cotten PA, Parker RM. Measuring conceptual health knowledge in the context of oral health literacy: preliminary results: Conceptual health knowledge in oral health literay. J Public Health Dent. 2010;70(3):197\u2013204.","journal-title":"J Public Health Dent"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-08632-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08632-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-08632-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:42:16Z","timestamp":1784853736000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-08632-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8632"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-08632-9","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"12 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval for the study was obtained from the Institutional Review Committee, BPKIHS, Dharan (Ref. No. 158\/080\/081-IRC). Written informed consent was obtained from all participants. This study adhered to the principles of the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1342"}}