BACKGROUND: Oral health literacy (OHL) might have an impact on oral health outcomes. Currently, relatively few related studies have been conducted among older people. The aim of this study was to explore the impacts of OHL on oral health outcomes in older adults in a cross-sectional design. METHODS: From November to December 2023, through the utilization of the cluster sampling approach, a questionnaire survey was carried out among elderly patients visiting the Prosthodontics Department of West China hospital of Stomatology. Data were collected through the general information questionnaire, the Chinese version of the Oral Health Literacy Scale, the Geriatric Oral Health Assessment Index, and oral examinations. Descriptive statistics, binary logistic regression, and poisson regression were used to analyse the data. RESULTS: A total of 407 valid questionnaires were recovered, with an effective retrieval rate of 98.79%. After adjustment for sociodemographic, economic and oral health behaviours, the results of the binary logistic regression indicated that the correlations between OHL and self-rated oral health were not statistically significant, while OHL was a predictor variable for dental expenditures within the past year (OR = 0.591
95%CI: 0.371-0.939), and the poisson regression revealed that OHL was a predictor variable of the quality of life (PR = 1.062, 95%CI: 1.030-1.084) and the number of lost teeth (PR = 0.917, 95%CI: 0.865-0.972). CONCLUSIONS: This study showed that OHL was closely associated with recent dental expenditure, oral health-related quality of life and the number of lost teeth. These findings could contribute to the planning and development of oral health education programs aimed at enhancing the OHL among the elderly population.