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Overview
Dentists and other health care providers commonly treat patients with limited “health literacy,” a term defined as the ability to read, understand and use health information to make appropriate health care decisions. The significant consequences and costs of inadequate health literacy were featured in a recent "Personal Health” column from the New York Times  .1
In 2004, the Institute of Medicine 2 reported that over 90 million individuals have low health literacy, which has often been associated with substandard health care and billions of dollars in annual health care costs. According to an October 2006 JADA editorial ,3 limited health literacy is a major barrier to optimal health for millions, who are much less likely to have regular access to preventive oral health care.
Limited understanding of medical and dental advice (written or spoken) affects patients of all ages, ethnicities, cultures and educational levels. As noted by the New York Times, even well-educated individuals, regardless of annual income, can have inadequate levels of health literacy. Another risk factor is patient age. A 2006 study 4 found that elderly patients with inadequate health literacy were almost twice as likely to die over a five-year period.
Effective communication by providers is a cornerstone of dental care and patient education supporting oral health interventions, treatment and management. With the increasing diversity of the U.S. population, provider-patient communications need to be more culturally and age sensitive than ever to support patients’ understanding and lower the risks of misinterpretation. To achieve more effective communications with patients, the following strategies are suggested in the New York Times article1:
- Assess the patient’s baseline understanding before providing extensive information;
- Using plain language instead of medical jargon or vague terms;
- Encouraging patients to ask questions; and
- Confirming the patient’s understanding by asking the patient to repeat instructions (or demonstrate actions).
Communication also plays a central role in the evidence-based approach to dental practice, where dentists integrate the best available scientific evidence in tandem with their clinical experience and the patient's treatment needs and preferences. To encourage patients’ involvement in the decision-making process, dentists can provide patients with relevant background information that adequately conveys the importance of oral health and maintaining healthy dental habits. Patient education on appropriate oral health care and hygiene should also be included in comprehensive health programs that clearly present health information to diverse patient populations.
The ADA supports initiatives to improve provider communication skills and strengthen oral health literacy among all patient populations to support quality care and improved oral health outcomes. Patients with limited health literacy may be offered additional education and assistance to improve their understanding of dental treatment options and preventive measures. Lastly, JADA's "For the Dental Patient" handouts are available to dentists and their patients as an educational resource on a wide range of oral health topics.
Footnotes
1Brody JE. The importance of knowing what the doctor is talking about. The New York Times, January 29, 2007. Available at: http://www.nytimes.com/2007/01/30/health/30brody.html?_r=1&ref=science&oref=slogin . Accessed January 29, 2007.
2Health literacy: a prescription to end confusion. Institute of Medicine, Washington, DC, 2004. Report brief available at: http://www.iom.edu/Object.File/Master/19/726/health%20literacy%20final.pdf .
Accessed January 29, 2007.
3Glick M. The Tower of Babel and health outcomes. Journal of the American Dental Association, 137(10):1356-58.
4Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, Newman AB, Rosano C, Rooks R, Rubin SM, Ayonayon HN, Schillinger D. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med 2006 Aug;21(8):806-12. Available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus
&list_uids=16881938&query_hl=14&itool=pubmed_docsum
Accessed
January 29, 2007.
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Page Posted February 2007
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