Part I: Introduction to Oral Health Literacy

Thank you for your interest in this course, Improving Oral Health Literacy: Teaching Primary School Students through the Lessons in a Lunch Box program. This is a course primarily dedicated to help ensure children and their families gain basic knowledge about taking care of their oral health.

Part I of the course introduces you to the definition of oral health literacy and provides important data to substantiate the need to elevate oral health knowledge.

The lessons taught through this program focus on bettering one’s oral health through disease prevention, wellness behaviors and ways to avoid the two dietary diseases which too often plague too many children attending Title 1 schools - tooth decay and obesity. Providing individuals with the necessary skills to obtain, understand, and act on dental-related information may increase their ability to cope with the demands of oral health maintenance and may ultimately lead to improved oral health outcomes. Education, resources and peer support can help to diminish health problems and risk which will lead to better health.

Documented by the Institute of Medicine in 2004, oral health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic oral health information and services needed to make appropriate health decisions and act on them.

According to the 2009 article in the American Academy of Pediatrics Journal, The Health Literacy of Parents in the United States: A Nationally Representative Study, a large proportion of US parents have limited health-literacy skills. 30% of parents in the United States have difficulty understanding and utilizing health information according to Yin and others. Decreasing literacy demands on parents, including simplification of health insurance and other medical forms, as well as medication and food labels, is needed.

The July 2011 issue of Social Science & Medicine article, Critical health literacy: A review and critical analysis, reports lower health literacy skills often lead to poorer health status, unhealthy behaviors, and poor health outcomes (Lee et al., 2011).

This list of consequences that limited oral health literacy imposes can render a comprehensive personal impact and as well a widespread social impact. In the publication by The Children’s Oral Health Institute, Code Red: The Oral Health Crisis in Your Classroom, the Cycle of Pain illustration further demonstrates the potential for pervasive devastation that can be imposed by limited oral health literacy.

It is clear dental disease can have negative and lasting effects on overall health and quality of life. The 2012 issue of the North Carolina Journal of Medicine documents in the Oral Health in North Carolina: Innovations, Opportunities, and Challenges article that across the US, “44% 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).

These are documented benefits of oral health literacy for children that have been researched and subsequently concluded evidenced-based text. The Lessons in a Lunch Box program focuses on, either directly or indirectly on each of these benefits.

Factors affecting oral health literacy are listed here. It is well-documented by Butler and others that socioeconomic status, age, sex, ethnicity and health insurance coverage can affect the relationship between literacy and health outcomes.

The diagrammatic explanation offered here shows the impact by culture and society, the education system, and the interaction that individuals have with the health system. Oral health literacy then directly impacts health, oral health, and other health outcomes and costs.

The Lessons in a Lunch Box program fits into this diagram where the focus is on the “Education System” aspect of the oral health literacy framework.

Evidence-based strategies to address health literacy are emerging, and the Lessons in a Lunch Box program is just one in the area of oral health literacy. The program simplifies written oral health and dietary information using a lunch box and a toothbrush case and is a targeted approach to patient education. It is an intervention that stays with the child to continuously reinforce oral health instructions and other educational lessons.

Methods to improve oral health literacy in children worth noting are included in this list. Improving oral health literacy seems to be associated with important health outcomes. Educational interventions effectively reduce health literacy-related disparities. This includes school-based programs like the Lessons in a Lunch Box program that will be discussed in Part 2 of this course.