Method: Philadelphia VAMC outpatients requesting comprehensive oral care were tasked to complete both REALD-30 (Rapid Estimate of Adult Literacy in Dentistry, the 30 word comprehension survey) and OHIP-14 (Oral Health Impact Profile, a subjective, hedonic impact score). Demographic information included Service-connected disability, caries and periodontal disease scores and years/theatres of military service.
Results: Over 12 study months, 120 questionnaires were completed by 97% males, (military discharge:30 years (range: 50y-1m; age: 46 years). One veteran discontinued the study. Mean REALD-30 score=16.25 (range 6-27, SD= 2.79). While OHL scores varied little by age, OHIP scores failed to show clinical correlation with dental disease measures, most likely because of low incidence of multiple high impact scores. Of interest, younger veterans typically reported good-excellent dental health and a dental visit within the previous year.
Conclusion: Study design establishes correlation of OHL with Quality of Life as independent of Service-Connected eligibility for VA dental care. While OHL positively correlated with oral health, the data set reveals a low level of reading ability and poor comprehension of dental jargon in these VA dental patients. Younger veterans did not differ from older veterans in failure to demonstrate competence in the OHL skill set, perhaps a function of lack of personal exposure to contemporary techniques. This first VA test of OHL and OHIP points to a pivotal role of literacy and underscores the need for reorientation of clinical decision-making practices which may impact dental/oral Quality of Life.