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Oral Health Literacy

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This collection of selected resources offers high-quality information about oral health literacy. Use the tools below for further searching, or contact us for personalized assistance.

Key Facts

  Share these facts to help improve the oral health of pregnant women, children, adolescents, and their families.

  • Low health literacy contributes to oral disease, which results in increased health care costs. 1
  • 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. 2
  • Dental anxiety and oral health literacy levels are related. To reduce oral health disparities, public health stakeholders need to find ways to overcome barriers resulting from high dental anxiety levels and low oral health literacy levels. 3
  • Low oral health literacy is associated with missing dental appointments. 4
  • Caregivers with low oral health knowledge are more likely to engage in behaviors (pre-chewing food for children, sharing utensils or toothbrush, delaying initiation of toothbrushing) that increase a child’s risk for developing dental caries. 5
  • Dental school clinics and other settings that provide oral health care should ensure that their materials are written at a level that is suitable for their target audience to enhance patients’ ability to make appropriate health-related decisions. 6
  • Oral health professionals should use simple language and seek to improve parents’ comprehension by using visual aids and verbal communication and techniques, such as questioning parents to confirm understanding of instructions and encouraging parents to ask questions. 7
  • Non-oral-health professionals such as nurse practitioners are uniquely positioned to contribute to preventing early childhood caries through health-literate and patient-centered communication. 8
  • In a study of pregnant and postpartum women who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), higher oral health literacy was associated with better oral health status. 9
  • A home visiting program model can introduce children and their families to oral-disease-prevention methods, improve oral health literacy, and establish a dental home, leading to increased use of oral health services among families with low incomes enrolled in or eligible for Medicaid. 10


  1. Horowitz AM, Kleinman DV. 2012. Oral health literacy: A pathway to reducing oral health disparities in Maryland. Journal of Public Health Dentistry 72(Suppl 1):S26–30.
  2. National Institute of Dental and Craniofacial Research, National Institutes of Health, U.S. Public Health Service, Department of Health and Human Services. 2005. The invisible barrier: Literacy and its relationship with oral health. A report of a workgroup sponsored by the National Institute of Dental and Craniofacial Research, National Institutes of Health, U.S. Public Health Service, Department of Health and Human Services. Journal of Public Health Dentistry 65(3):174–182.
  3. Shin WK, Braun TM, Inglehart MR. 2014. Parents’ dental anxiety and oral health literacy: Effects on parents’ and children’s oral health-related experiences. Journal of Public Health Dentistry 74(3):195–201.
  4. Baskaradoss JK. 2016. The association between oral health literacy and missed dental appointments. Journal of the American Dental Association 147(11):867-874.
  5. Finnegan DA, Rainchuso L, Jenkins S, Kierce E, Rothman A. 2016. Immigrant caregivers of young children: Oral health beliefs, attitudes, and early childhood caries knowledge. Journal of Community Health 41(2):250–257.
  6. Tam A, Yue O, Atchinson KA, Richards JK, Holtzman JS. 2015. The association of patients’ oral health literacy and dental school communication tools: A pilot study. Journal of Dental Education 79(5):530–538.
  7. Richman JA, Huebner CE, Leggott PJ, Mouradian WE, Mancl LA. 2011. Beyond word recognition: Understanding pediatric oral health literacy. Pediatric Dentistry 33(5):420–435.
  8. Koo LW, Horowitz AM, Radice SD, Wang MQ, Kleinman DV. 2016. Nurse practitioners’ use of communication techniques: Results of a Maryland oral health literacy survey. PLoS One 11(1):e0146545.
  9. Brickhouse TH, Haldiman RR, Evani B. 2013. The impact of a home visiting program on children’s utilization of dental services. Pediatrics 132(Suppl 2):S147–152.
  10. Meija GC, Weintraub JA, Cheng NF, Grossman W, Han PZ, Phipps KR, Gansky SA. 2011. Language and literacy relate to lack of children’s dental sealant use. Community Dentistry and Oral Epidemiology 39(4):318–324.

OHRC Publications

This section contains OHRC-produced materials.


Barzel R. 2007. A way with words: Guidelines for writing oral health materials for audiences with limited literacy. Washington, DC: National Maternal and Child Oral Health Resource Center, 2 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This tip sheet provides ideas to help those who produce educational oral health materials make the materials easy for everyone to understand. It offers suggestions for how to choose words; set an appropriate tone; and craft sentences, paragraphs, lists, and headings that communicate most effectively with people with limited literacy. Suggestions for how to design documents and how to present unfamiliar terminology are also included. [Funded by the Maternal and Child Health Bureau]


OHRC Library

This section contains recent materials, not including OHRC-produced materials.


Booker WJ, Grant LE. 2014. Improving oral health literacy: Teaching primary school students through the Lessons in a Lunch Box program. Dallas, TX: Procter and Gamble Company, 1 v

Procter and Gamble Company
Cincinnati, OH Telephone: (800) 543-2577
Website: http://www.dentalcare.com
Available from the website.

This course for oral health professionals outlines steps for implementing the Lessons in a Lunch Box program, a strategy to address health literacy with elementary school students and their families. Contents include an overview of health literacy, information on how to present the program and register schools for the program, and resources. Topics include routine oral health maintenance, oral disease prevention, healthy eating, and careers in dentistry. Continuing education credits are available.


GBSM. 2013. Oral health 2014: Delaware–An oral health literacy strategic communications plan. Dover, DE: Delaware Health and Social Services, Bureau of Oral Health and Dental Services, 24 pp

Delaware Health and Social Services, Bureau of Oral Health and Dental Services
Jesse Cooper Building 417 Federal Street
Dover, DE 19901

Telephone: (302) 744-4554
Fax: (302) 661-7229
Website: http://dhss.delaware.gov/dph/hsm/ohphome.html
Available from the website.

This report provides an overview of an oral health literacy campaign in Delaware, describes the campaign's communications approach, and discusses sustainability and next steps. Contents include information about the campaign's mission; successes; challenges; impact; and strategic levers, goals, and objectives. Additional topics include campaign strategies, collaborative structure, critical partners, stakeholders, target audiences, research, message platform, branding and identity, tactics, action steps, written materials, interactive tools, mass media, and grassroots community outreach. Information about funding and costs, measures of success, and a conclusion are also provided.


New York State Oral Health Center of Excellence. 2015. Oral health literacy toolkit. Rochester, NY: New York State Oral Health Center of Excellence, 55 pp

New York State Oral Health Center of Excellence
259 Monroe Avenue, Level B
Rochester, NY 14607

Telephone: (585) 325-2280
E-mail: info@nysoralhealth.org
Website: https://nysoralhealth.squarespace.com
Available from the website.

This toolkit provides information and resources for implementing interventions to promote and improve oral health literacy as part of the New York State Department of Health prevention agenda. Contents include information about the magnitude of the problem, the importance of oral health literacy, the potential reach and relative impact of interventions to improve oral health literacy, and suggested interventions for specific sectors.


Petty D. 2015. Eliminating tooth decay in the Karen refugee population. Plymouth, MN: Minnesota Oral Health Coalition, 1 video (40 min, 27 sec)

Minnesota Oral Health Coalition
4190 Vinewood Lane N, #111-416
Plymouth, MN 55442

Telephone: (763) 381-1701
E-mail: info@minnesotaoralhealthcoalition.org
Website: http://www.minnesotaoralhealthcoalition.org
Available from the website.

This video describes qualitative and quantitative research on oral health knowledge and behavior within the Karen refugee community in Minnesota, and how the results were used to target educational oral health topics to Karen leaders, parents, adolescents, and children. The video covers evidence-based oral health topics for the Karen refugee community and strategies for collaboration among oral health professionals, educators, and refugee community leaders.


Yarbrough C, Nasseh K, Vujicic M. 2014. Key differences in dental care seeking behavior between Medicaid and non-Medicaid adults and children. Chicago, IL: American Dental Association, Health Policy Institute, 21 pp

American Dental Association, Health Policy Institute
211 East Chicago Avenue
Chicago, IL 60611-2678

Telephone: (312) 440-2500
Website: http://www.ada.org/en/science-research/health-policy-institute
Available from the website.

This brief describes adult Medicaid beneficiaries' understanding of the dental benefits available to them and, where applicable, to their children. The brief also describes oral health knowledge and oral-health-care-seeking behavior, comparing outcomes among adult Medicaid beneficiaries with outcomes among those enrolled in other health insurance plans.


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