Determinants of Oral Health Literacy Among Middle-Aged and Older Adults with Diabetes: A Cross-Sectional Comparative Study

Background Oral health literacy (OHL) is a critical determinant of oral health and self-care, particularly for individuals with diabetes who are at increased risk of oral complications. Although interprofessional education is increasingly integrated into diabetes management, little is known about how OHL differs across healthcare settings in Taiwan. This study compared OHL levels among middle-aged and older adults with diabetes attending diabetes education clinics and general dental clinics. Methods A cross-sectional comparative study was conducted between February and December 2024 in southern Taiwan. A total of 187 adults aged ≥ 45 years with type 2 diabetes participated, including 115 from a diabetes education clinic and 72 from a dental clinic. Data were collected through face-to-face questionnaires, including demographic characteristics and the validated Mandarin version of the Oral Health Literacy–Adult Questionnaire (OHL-AQ). Descriptive statistics, chi-square tests, independent-samples t-tests, and ordinal logistic regression were performed using SPSS version 22.0. Results The overall mean OHL score was 11.37 ± 2.86. Participants attending diabetes education clinics demonstrated significantly higher OHL than those visiting dental clinics (12.21 ± 2.44 vs. 10.11 ± 3.04; p < 0.001). Significant group differences were also observed in reading comprehension, numeracy, and listening comprehension (all p < 0.05). Ordinal logistic regression indicated that attending a diabetes education clinic was associated with greater odds of higher OHL (OR = 3.69; 95% CI 1.97–6.93; p < 0.001). Female sex and higher education level (college or above) were also positively associated with adequate OHL (p < 0.01). Conclusions Middle-aged and older adults with diabetes attending diabetes education clinics had significantly better oral health literacy than those visiting dental clinics. The findings highlight the value of interprofessional health education and suggest that incorporating oral health promotion into diabetes education may improve health outcomes. Tailored strategies targeting men and individuals with lower education levels are warranted to reduce literacy disparities.