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Agency for Healthcare Research Quality

Health Literacy

Nearly one-third of adults show low literacy on dental health

Individuals with little oral health knowledge and low literacy levels typically do not understand oral health instructions or the importance of oral hygiene and regular dental checkups. As a result, they may wait to visit a dentist until they have a painful cavity or abscess. Dentists can improve dental care by addressing patients' ignorance and confusion about oral health, suggest researchers at the University of North Carolina at Chapel Hill.

The researchers used the 30-item Rapid Estimate of Adult Literacy in Dentistry (REALD) word recognition test (which generally correlates with reading ability and comprehension) among predominantly low-income adults seeking care at two North Carolina dental practices in 2006. They also interviewed the patients about demographics, health behaviors, and knowledge of dental cavities and periodontal disease (using two questions).

Nearly 31 percent of the adults viewed their oral health as fair or poor, and 31 percent had not visited a dentist in the past year. Close to one-third of patients had low literacy, that is, they could correctly pronounce fewer than 22 of the 30 words on the REALD.

After adjusting for other factors, adults who incorrectly answered one or two of the knowledge questions and who reported fair or poor oral health were nearly six times and three times, respectively, more likely to have low oral health literacy, than their reference group. Not having had a dental care visit in the last year was not associated with literacy, but this result was confounded by other factors. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).

More details are in "Oral health literacy among adult patients seeking dental care," by Michaela Jones, Ph.D., M.D., Jessica Y. Lee, D.D.S., M.P.H., Ph.D., and Gary Rozier, D.D.S., M.P.H., in the September 2007 Journal of the American Dental Association 138(9), pp. 1199-1208.

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