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Background and Objectives: It is important to note that Oral Health Literacy (OHL) not only pertains to dental health but also has a broader impact on overall quality of life. Therefore, this cross-sectional study aimed to assess the level of OHL in the adult population of Tehran, Iran. Materials and Methods: A sample of 700 Iranian adults (Tehran), aged 18-64 years, participated in this study (October 2021 and March 2022). A researcher-developed questionnaire was used to collect data on demographic variables and OHL. The questionnaire consisted of four domains: cognitive, behavioral, media, and communication skills. The data was analyzed by software SPSS 19. Data analysis included descriptive statistics, independent-samples t-tests, one-way analysis of variance (ANOVA), chi-square tests, and multiple regression analysis. Statistical significance was set at P < 0.05. Results: The average age of the subjects was 35.50±8.87 years, ranging from 18 to 61 years. The mean OHL score was 67.62±15.53, indicating a moderate level of OHL. Among the dimensions of the questionnaire, cognitive skills received the highest scores and Communicative skill lowest. The results revealed significant associations between OHL and demographic variables. Multiple regression analysis showed that income, education level (academic and below diploma), and marital status (married) significantly predicted OHL. Conclusion: This study highlights the need for improved OHL in the Iranian adult population. The findings suggest that educational interventions targeting loweducated individuals and specific demographic groups could help enhance OHL. Efforts should be directed towards improving communication skills in oral health settings. [ABSTRACT FROM AUTHOR]

This study aimed to develop and rigorously evaluate the Test of Oral Health Literacy in Adults (TOHLA) for the Iranian population, addressing the limitations of existing oral health literacy (OHL) measurement instruments and contributing to the literature on OHL assessment. The development of the TOHLA involved a qualitative approach, which included a comprehensive literature review and semi-structured interviews with a panel of 15 experts from diverse fields and 22 Iranian adults aged 18 to 64 years. The instrument was designed with 48 items categorized into four domains: cognitive skill, communication skill, media skill, and functional skill. Content validity was established through expert input and content validation indices. Construct validity was supported by factor analysis, and concurrent validity was assessed by comparing TOHLA scores with demographic variables. Internal consistency and test-retest reliability analyses were performed to assess the instrument's reliability. The psychometric evaluation of the TOHLA demonstrated strong content validity, construct validity, concurrent validity, internal consistency, and test-retest reliability. The instrument exhibited a high level of internal consistency, with a Cronbach's alpha coefficient of 0.81 for the entire scale. Test-retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.83. Concurrent validity analysis showed statistically significant associations between OHL scores and demographic variables, supporting the instrument's overall performance. The TOHLA overcomes the weaknesses observed in existing instruments and offers a comprehensive tool with strong psychometric properties to assess the OHL of the Iranian adult population. Researchers, policymakers, and healthcare providers can utilize the TOHLA to address oral health challenges and enhance overall oral health outcomes among Iranian adults.