A pilot study to assess oral health literacy by comparing a word recognition and comprehension tool.

BACKGROUND: Oral health literacy is important to oral health outcomes. Very little has been established on comparing word recognition to comprehension in oral health literacy especially in older adults. Our goal was to compare methods to measure oral health literacy in older adults by using the Rapid Estimate of Literacy in Dentistry (REALD-30) tool including word recognition and comprehension and by assessing comprehension of a brochure about dry mouth. METHODS: 75 males and 75 females were recruited from the University of Connecticut Dental practice. Participants were English speakers and at least 50 years of age. They were asked to read the REALD-30 words out loud (word recognition) and then define them (comprehension). Each correctly-pronounced and defined word was scored 1 for total REALD-30 word recognition and REALD-30 comprehension scores of 0-30. Participants then read the National Institute of Dental and Craniofacial Research brochure "Dry Mouth" and answered three questions defining dry mouth, causes and treatment. Participants also completed a survey on dental behavior. RESULTS: Participants scored higher on REALD-30 word recognition with a mean of 22.98 (SD = 5.1) compared to REALD-30 comprehension with a mean of 16.1 (SD = 4.3). The mean score on the brochure comprehension was 5.1 of a possible total of 7 (SD = 1.6). Pearson correlations demonstrated significant associations among the three measures. Multivariate regression showed that females and those with higher education had significantly higher scores on REALD-30 word-recognition, and dry mouth brochure questions. Being white was significantly related to higher REALD-30 recognition and comprehension scores but not to the scores on the brochure. CONCLUSIONS: This pilot study demonstrates the feasibility of using the REALD-30 and a brochure to assess literacy in a University setting among older adults. Participants had higher scores on the word recognition than on comprehension agreeing with other studies that recognition does not imply understanding.

Geriatrics education in U.S. dental schools: where do we stand, and what improvements should be made?

The number of adults above sixty-five years of age in the United States will expand considerably over the next thirty years. However, many dentists believe that their dental education did not adequately prepare them to treat an older adult population. Consequently, it is important to review dental curricula to determine where these gaps in education may occur and what can be done to address them in order to improve access to care. In this study, information was gathered from the websites of sixty-two U.S. dental schools in order to understand the types of geriatric courses offered. This review revealed that while most schools (89 percent) provide their predoctoral students with some education in geriatrics, only fourteen (22.6 percent) offer clinical training specifically for older adult care. In addition, forty-three schools (69 percent) include a geriatric component in either their General Practice Residency or Advanced Education in General Dentistry programs or have a certificate program in geriatric dentistry. Only about 23 percent of the schools offer a continuing education course in geriatrics at any one time. Previous studies have shown that clinical training is the most effective method of increasing students' confidence in treating older patients. Consequently, dental schools should work to incorporate clinical experience into geriatric education to prevent widening an existing gap in older adult oral health care.