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Am J Public Health. 2014 Jul;104(7):e85-91. doi: 10.2105/AJPH.2014.301930. Epub 2014 May 15.

Health literacy: a pathway to better oral health.

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  • 1Yi Guo and Keith E. Muller are with the Department of Health Outcomes and Policy, College of Medicine, and Henrietta L. Logan, Virginia J. Dodd, John G. Marks, and Joseph L. Riley III are with the Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville.



We examined whether health literacy was associated with self-rated oral health status and whether the relationship was mediated by patient-dentist communication and dental care patterns.


We tested a path model with data collected from 2 waves of telephone surveys (baseline, 2009-2010; follow-up, 2011) of individuals residing in 36 rural census tracts in northern Florida (final sample size n = 1799).


Higher levels of health literacy were associated with better self-rated oral health status (B = 0.091; P < .001). In addition, higher levels of health literacy were associated with better patient-dentist communication, which in turn corresponded with patterns of regular dental care and better self-rated oral health (B = 0.003; P = .01).


Our study showed that, beyond the often-reported effects of gender, race, education, financial status, and access to dental care, it is also important to consider the influence of health literacy and quality of patient-dentist communication on oral health status. Improved patient-dentist communication is needed as an initial step in improving the population's oral health.

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