Abstract
BackgroundThis article presents findings from a scoping review of tools used to measure oral health literacy. Internationally, interest in oral health literacy is driven by oral health disparities, particularly for disadvantaged groups, with conditions such as dental caries and periodontal disease contributing substantially to the global burden of disease. The increasing focus on measuring oral health literacy aligns with reasons for measuring broader health literacy, that is, by assessing oral health literacy, decisions can be made about instigating interventions at policy and practice level to improve individual and population level oral health. There are numerous tools available that measure oral health literacy using a range of indicators.MethodsA scoping review was designed to map the existing tools designed to measure oral health literacy (OHL). Key search terms were developed and mapped. Selected databases were used that identified 32 relevant studies reporting a range of OHL tools.ResultsWe identified 32 articles that reported a range of oral health literacy tools. Many of the studies used the Rapid Estimate of Adult Literacy in Dentistry (REALD) and/or the Test of Functional Health Literacy in Dentistry (ToFHLiD) that were developed from earlier tools designed to measure broader health literacy. These tools have been widely criticised for providing only an approximate measure of OHL based mainly on word recognition. A number of newer tools have included new measures of oral health literacy including numeracy and oral health conceptual knowledge however tools that measure important indicators of oral health literacy such as service navigation are rare.ConclusionsFindings from this scoping exercise confirm our findings from preliminary scans that the majority of tools are heavily biased towards word recognition, numeracy and reading skills, rather than what this means in terms of health behaviours and service utilisation. More recent developments have attempted to incorporate other aspects considered important, including decision making and service navigation. The incorporation of these aspects into newer tools will provide oral health researchers and policy makers with further evidence of the importance of oral health literacy when designing interventions to improve oral health.
Highlights
This article presents findings from a scoping review of tools used to measure oral health literacy
The most frequently used are those based on the Rapid Estimate of Adult Literacy in Medicine (REALM) developed by Davis and colleagues in 1993 [32]
Gironda and colleagues [49] developed a shortened version, REALMD-20, for clinicians to detect limited medical/ dental health literacy in patients attending for treatment in dental/medical clinics
Summary
There are numerous tools available that measure oral health literacy using a range of indicators. This article presents findings from a scoping review of tools used to measure oral health literacy. Interest in this topic, as a domain of health literacy, and a determinant of health, has been growing since the late 1990s. The economic costs associated with poor oral health are well-documented [7,8] and the association between oral health, and general health and wellbeing have been noted in numerous studies, with poor oral health impacting on quality of life across the lifespan [2,7,9]. Oral health extends beyond dental disease, with a healthy mouth central to the capacity to eat, talk and lead meaningful lives free of disease, pain or embarrassment [3,10]
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