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1
Introduction1
Health literacy is the degree to which individuals have the capacity to obtain,
process, and understand basic health information and services needed to make
appropriate health care decisions (IOM, 2004).
The Institute of Medicine (IOM) Roundtable on Health Literacy
focuses on bringing together leaders from the federal government, foun-
dations, health plans, associations, and private companies to address
challenges facing health literacy practice and research and to identify
approaches to promote health literacy in both the public and private
sectors. The roundtable serves to educate the public, press, and policy
makers regarding the issues of health literacy, sponsoring workshops to
discuss approaches to resolve health literacy challenges. It also builds
partnerships to move the field of health literacy forward by translating
research findings into practical strategies for implementation.
The Roundtable held a workshop March 29, 2012, to explore the field
of oral health literacy. The workshop was organized by an independent
planning committee in accordance with the procedures of the National
Academy of Sciences. The planning group was composed of Sharon
Barrett, Benard P. Dreyer, Alice M. Horowitz, Clarence Pearson, and Rima
Rudd. The role of the workshop planning committee was limited to plan-
ning the workshop. Unlike a consensus committee report, a workshop
1
This workshop was organized by an independent planning committee whose role was
limited to identification of topics and speakers. This workshop summary was prepared by
the rapporteur as a factual summary of the presentations and discussions that took place
at the workshop. Statements, recommendations, and opinions expressed are those of in-
dividual presenters and participants, and are not necessarily endorsed or verified by the
Roundtable or the National Academies, and they should not be construed as reflecting any
group consensus.
1
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2 ORAL HEALTH LITERACY
summary may not contain conclusions and recommendations, except as
expressed by and attributed to individual presenters and participants.
Therefore, the summary has been prepared by the workshop rapporteur
as a factual summary of what occurred at the workshop.
Oral health and oral health literacy are the focus of interest at the
national level as demonstrated in the recommendations from two recent
IOM reports and in the objectives of Healthy People 2020 (HHS, 2010a;
IOM, 2011a,b). Although the field of oral health literacy is less well devel-
oped than health literacy, the roundtable was interested in exploring find-
ings from research in this area and how such findings are being translated
into oral health practice. In addition, the Roundtable was interested in
the intersection between oral health literacy and health literacy. It has
been established that limited health literacy is associated with inaccurate
knowledge about preventive measures such as water fluoridation, dental
care visits, dental caries severity, and oral health–related quality of life.
For example, nationally only “44 percent of adults with less than basic
health literacy skills had a dental visit in the preceding year compared
with 77 percent of those with proficient health literacy skills” (Rozier,
2012).
The public and health care providers are largely unaware of the basic
risk factors and preventive regimens for many oral diseases. For example,
the fact that dental caries is both infectious and preventable is not gener-
ally known by the public and most health care providers (Fejerskov, 1997;
Isong et al., 2012; Roberts-Thomson, 2002). The relationship between good
oral health and overall health and well-being is also not well understood
(DeStefano et al., 1993; HHS, 2000b; Jackson et al., 2011). Oral disease
is expensive in terms of teeth, time, and money and results in pain,
disfigurement, loss of school and work days, and even death when left
untreated (Dye et al., 2007; Jackson et al., 2011; Petersen and Kwan, 2011;
Petersen et al., 2005; Seirawan et al., 2012). There are profound dispari-
ties in oral health with morbidity and mortality concentrated among the
most vulnerable; those who are poor, have a limited level of education,
racial ethnic minorities, and the elderly (Dye et al., 2007; Edelstein, 2002;
Mouradian, 2000). These are essentially the same individuals who have
low levels of health literacy (Eichler et al., 2009; IOM, 2004; Weiss, 2003).
The workshop on oral health literacy was moderated by Roundtable
chair, George Isham, and featured presentations from invited speakers.
These presentations make up the chapters that follow. Each topic (chap-
ter) includes one or more presentations that are followed by a group
discussion led by Roundtable members. Chapter 2 presents a summary
of the keynote address on the importance of oral health literacy. Chapter
3 provides background on the issue of oral health and the role of health
literacy in addressing oral health problems. Chapter 4 examines how oral
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INTRODUCTION 3
health literacy can be assessed within care systems and within the envi-
ronment. Chapter 5 summarizes the experience of several effective oral
health literacy programs. Chapter 6 describes three state-based oral health
initiatives. Chapter 7 provides an overview of national activities in oral
health literacy. The report concludes with Chapter 8, a general discussion
of the day’s proceedings.
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