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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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