Barriers to Oral Health Education: The Readability of Oral Health Literature for Lay Populations

One mechanism to prevent oral disease is to provide informational literature on oral health topics. This study assessed the reading grade level (RGL) of informational oral health literature, and estimated the proportion of adults in a metropolitan area who may be unable to comprehend the material, based on Census data on attained levels of education.

The RGL of twenty three oral-health information documents was assessed by three independent raters using the Fry Readability Formula. Inter-rater reliability ranged from .81 to .98. Four documents had an RGL of “College”; seven had an RGL of “high school.” Ten documents had an RGL of grade seven or less.

Based on census data on grade level attained in the study population, more than 50% of the population had levels of education less than college. Ten percent of the population had a level of education less than 10th grade and approximately two percent of the population had less than a fifth grade education. The CDC recommends an RGL of six to seventh grade for health-information documents. This study found a significant disjuncture between the readability of oral-health information documents and the potential ability of the target population to understand the material.