Oral health literacy from a person-centered focus in the United States: a narrative review.

BACKGROUND: The concept of oral health literacy (OHL) is well recognized in the literature as a contributing factor to poor oral and systemic health outcomes. Oral health literacy is a combination of knowledge and skills acquired over time through oral health experiences. An OHL framework helps identify barriers related to OHL such as individual demographics, environmental factors, and access to oral health information. This framework will be used to examine who in the literature is being measured for OHL, explore the various interventions for improved OHL, and investigate who should be held responsible for improving OHL. METHODS: Evidence-based, peer reviewed, manuscripts were examined to determine who is being measured for OHL and who is responsible for improving OHL and oral health outcomes. Electronic databases, PubMed, Google Scholar, ProQuest Health and Medicine, and EBSCO Complete were searched for literature published on OHL from 2018-2024. Four reviewers screened manuscripts for inclusion/exclusion criteria and categorized manuscripts according to OHL subject, OHL interventions, and OHL provider. RESULTS: Out of 12,961 manuscripts, 58 met inclusion criteria and were reviewed and categorized according to the OHL population focus, OHL intervention or measure type, and who was recommended to provide future OHL skills. From these main categories, parents and caregivers were most often measured for OHL with an OHL survey instrument. When interventions were applied, they generally consisted of oral health education and behavioral modification. The responsibility for improved OHL was most often placed on medical and dental providers. CONCLUSIONS: OHL is a highly researched topic in the literature. However, OHL is often focused on one social identity, such as being a caregiver or a particular race/ethnicity. Power dynamics between patients and providers, and within communities and health care systems can further perpetuate challenges with improving OHL and positive oral health experiences. Using an OHL framework, which includes identifying multiple social identities and recognizing environmental barriers, can help identify individuals who would benefit from assistance in improving their OHL.