The role of health literacy in achieving oral health for elders.

A mismatch between the literacy skills of individuals and the demands of oral health services may erect an unnecessary barrier to preventive care and treatment. Findings from the 1992 survey of adult literacy in the United States indicate that more than two-thirds of adults over the age of sixty were limited in their ability to use written health materials in prose format, had problems finding and processing quantitative information, and were very limited in their ability to use documents such as forms, lists, charts, and graphs. Thus, many older adults face barriers to oral care, to needed information, to full participation in decision making and informed consent, and for follow-up activities. The pathways between literacy and health outcomes are being examined, and the body of literature linking literacy to health continues to grow. However, similar studies examining literacy and oral health outcomes have not yet been undertaken. Research in this area might well begin with consideration of the skills needed to perform important oral health tasks. Rigorous studies of the impact of improved communication strategies on elders' access to care, participation in services, and action steps would lend insight into needed change.