Improving America's Oral Health Literacy

By Dr. Joseph Dill, Head of Dental Science for the Delta Dental Institute and Vivian Vasallo, Executive Director of the Delta Dental Institute


"Health literacy" may be a new term for many Americans; however, it is a critical part of overall health and a necessity for understanding how to navigate today's health care system.

Being health literate affects whether patients know how to make an appointment with a health care provider, recognize how different physicians fit within their insurance plan, and understand the advice and treatment received during a visit. Health literacy empowers patients to make informed decisions about their oral and overall health care, which translates into improved health and quality of life.

Health literacy was first defined by the World Health Organization as "the ability of individuals to gain access to, understand, and use the information in ways which promote and maintain good health." In the Delta Dental Institute's recent white paper, researchers sought to apply this concept to oral health and examine how dental health professionals, employers, and other stakeholders can help Americans make more informed decisions. The end goal was to provide actionable solutions to help dental professionals, dental insurers, and policymakers reframe their approach to oral health literacy.

The research shows that Americans recognize the connection between oral health and overall health, but a discrepancy in outcomes remains due in part to low levels of oral health literacy. In general, low health literacy is associated with poorer outcomes and lower-than-average use of health care services. Applied to an oral health setting, this can lead to the delay or avoidance of dental care, which can cause routine problems to become serious dental emergencies.

But who is responsible for improving the current state of Americans' oral health literacy? The burden does not fall solely on patients to inform themselves—dental health professionals, insurers, employers, and brokers all have a responsibility to facilitate better oral health literacy.

In the paper, the researchers proposed a new term, "health provider literacy," to specifically address the role of health professionals in this pursuit. It is defined as "the degree to which providers obtain, process, understand, evaluate, and act on information needed to address a patient's needs using current evidence-based practices as described in plain language to ensure the patient understands." Plain language is especially crucial in an oral health context, as the literature suggests that consumers struggle with both medical and dental terminology and understanding their dental benefits, which can present a significant barrier to accessing and properly utilizing oral health care services even if they have adequate coverage.

The white paper identified three recommendations to address oral health literacy: develop dental health literacy training modules; adapt the after-visit summary for use in dentistry; and provide plain-language clinical and dental insurance educational information to all patients. The paper also reinforced that oral health literacy is an essential component of an effective patient-centered, team-based practice.

The paper also recommends that dental professionals be conscious of social determinants of health—such as diet, employment status, and geographic location—which can exacerbate oral health literacy problems.  It also provides references to available health literacy training modules for professionals.

A research-based, data-driven reframing is required to look beyond the individual encounter in a dentist's chair and fundamentally change the dental profession's approach to improving oral health literacy. We encourage policymakers, dental health professionals, employers, insurers, and other stakeholders to take this as a call to action to examine the many factors that affect a patient's health outcomes, including their oral health literacy level.

The full white paper can be downloaded on the Delta Dental Institute's website here.