Even though limited health literacy can affect anyone, those who struggle with general literacy are the most severely impacted. Many people with limited literacy skills develop a wide range of coping mechanisms and “work-arounds” to help them function in society and to keep other people from finding out about their limitations. You can rarely tell just by looking that someone has low literacy, and patients are unlikely to volunteer this information. In fact, many people who don’t read well—or who don’t read at all—have never even told their close friends or family members. It’s important, then, for dental professionals to be aware of non-verbal warning signs that may indicate low literacy.
It’s important to note, however, that the presence of these behaviors may not always mean that low literacy is a factor. Similarly, the absence of these behaviors is not a guarantee that a patient reads well or has achieved adequate understanding. Nonetheless, being aware of certain “red flags” can help identify patients for whom we ought to take extra care when communicating.