Factors Influencing Oral Health Literacy in Older People: A Life-Course Perspective.

Abstract

Introduction: Oral health literacy (OHL) influences older adults' capacity to obtain, process and apply oral health information for self-care and decision-making. Evidence on OHL in community-dwelling older adults in Chile remains scarce. This study explored the factors shaping OHL among Chilean community-dwelling older adults.

Methods: A qualitative exploratory study was conducted using the Grounded Theory approach. Older adults (≥ 65 years) were purposively sampled from three municipalities in Santiago, Chile, representing different levels of social vulnerability. Thirteen in-depth, face-to-face, semi-structured interviews were conducted. The interviews were audio-recorded, transcribed verbatim and analysed iteratively using constant comparison and open, axial and selective coding, categorising the answers to identify emerging topics until reaching saturation. Data triangulation included interviews, field observations and document reviews.

Results: Findings emerged into two overarching dimensions shaping OHL across the life course: upstream and downstream factors. Upstream factors included contextual factors, provider-related factors and system-related factors. Downstream factors encompassed individual and behavioural aspects that influenced access to dental care and attention.

Conclusion: OHL in older adults is shaped by cumulative life-course experiences across structural, social and individual domains. Addressing OHL requires integrated public policies, professional training in patient-centred communication and community-based strategies targeting social determinants to promote equitable oral health in older age.