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The state of the evidence suggests that in the dental setting, oral health literacy is directly associated with a variety of dental health outcomes, including performance on a clinical examination (according to the criteria of The American Academy of Pediatric Dentistry [84] or American Academy of Periodontology [85] definitions of gingivitis).
Regarding pain outcome measures, the literature indicates that there are a number of oral health literacy instruments that have been investigated. The ToFHLiD has been validated against other measures of health literacy such as REALD-99, but it was not directly validated against pain outcomes. Although the ToFHLiD was found to have a good correlation with REALD-99 in one study [50], this correlation was stronger between dental and medical literacy. A better understanding of the association between oral health literacy and pain outcomes is needed. Recently, Park and colleagues [51] validated another oral health literacy instrument, the Rapid Estimate of Adult Literacy in Medicine-Dentistry (REALM-D) [52], as a predictor of pain during scaling and root planning, although the authors did not report the association between oral health literacy as a predictor of pain, they did report that oral health literacy predicted changes in pain during a dental procedure. It is possible that oral health literacy predicts pain outcomes from mechanical stimulation, such as procedural pain and also clinically meaningful outcomes, such as successful treatment of painful oral diseases. Further research is needed to determine whether oral health literacy predicts oral health or dental health outcomes.
Acute and chronic dental pain conditions can be managed most effectively with nonopioid medications, and consequently oral health literacy is a crucial component of pain management. However, pain is a complex and multifaceted phenomenon, and many of the tools used to measure oral health literacy in this review were designed for the general or systematic population (31,43,62,74,127). The tools reviewed in this paper were designed to predict, identify, and assess patients at risk of medication errors, their ability to use medications safely, and whether they had good oral health practices. Testing oral health literacy with a specific group, such as a patient population, or in a specific setting to determine the accuracy of the tools for that group has not been reported (64,81). 827ec27edc