Model of Stratified Oral Health Literacy (MELSO): Integrating Social Determinants, Education, and Health Outcomes

Background/Objectives: Oral health literacy (OHL) and oral health outcomes are socially patterned. This article proposes the Model of Stratified Oral Health Literacy (MELSO) to specify how educational resources and service conditions may shape the development and use of OHL. Methods: A narrative conceptual synthesis integrated health literacy theory, social determinants frameworks, and educational perspectives into five interrelated levels. No new participant data were collected or analysed. Results: MELSO links structural context, educational and cultural capital, functional, interactive, and critical OHL, self-management behaviours, and oral health outcomes. Its proposed added value is the joint specification of educational mediation, access-related moderation, and competency-specific associations within oral health. Five testable hypotheses and a staged strategy for measurement development and empirical evaluation are presented, including comparisons with simpler models. Conclusions: MELSO is a hypothesis-generating framework rather than a validated explanatory model or measurement instrument. Its utility depends on empirical evidence that the proposed relationships are distinguishable, reproducible, and informative beyond existing approaches.