Conceptualisations of the social determinants of health among first‐year dental students

Abstract

Background Social conditions have a significant impact on the health of individuals and populations. While the dental curriculum is focused on teaching students about the diseases that affect the dentition and oral structures from a biomedical perspective, education about the social determinants of health is frequently regarded as less important. Thus, it occupies a smaller and disconnected part of the dental curriculum. The aim of this study was to explore the ways dental students conceptualised the social determinants of health after one year in dental school. Methods Reflective statements written by first year dental students at the end of the first year of study were collected. This qualitative study has an interpretivist basis and a thematic analysis of the reflections was conducted by two researchers. Metzl’s structural competencies were used as a further analytic device. Results Four inter-related themes were identified: First, professional attitudes taken up by students influence their conceptions. Second, structural barriers to students understanding social determinants of health generate partial understandings. Thirdly, the social gulf that exists between the student body and people of different circumstances provides context to understanding the student’s perspectives. Finally, we described how students were learning about the social determinants of health over the academic year. Conclusions Dental students face several challenges when learning about the social determinants of health, and translating these learnings into actions is perhaps even more challenging. Metzl’s structural competencies provide a framework for advancing students’ understandings. One of the most important findings of this research study is that coming to an understanding of the social determinants of health requires sustained attention to social theories, practical experiences as well as institutionalised attitudes that could be achieved through an intentional curriculum design.

Curriculum mapping of health promotion competencies in dental and oral health training programmes in Australia

“…A study was undertaken in Canada assessing students' confidence in competency domains once graduated found students were 90% confident in oral health education, but only 50% confident in their health promotion skills 46 . This lack of training and confidence would reinforce the belief that health education is the only approach to preventing disease and addressing social determinants 41 . Another factor that may provide insight into the reliance on health education is the structure of funding in dentistry.…”

“…However, half of the dental courses were not explicitly meeting some of the health promotion competencies, for example understanding theories and principles of health promotion. This could be attributed to technical and restorative competencies dominating the dental curriculum 41 . Previous authors have criticised the biomedical model prevailing in dental curricula and as a result, it reduces dentistry to ‘drill and fill’ and neglects the social determinants of health 42 .…”

Relationships between ENDS-Related Familial Factors and Oral Health among Adolescents in the United States

“…Similarly, ENDS use can also be linked to poorer oral health, and the social history that oral health providers obtain should include asking teens about their smoking habits—including ENDS use. Even though social history is an important part of a comprehensive oral health assessment [ 41 ], dentists typically place less emphasis on social history taking [ 42 ]. This lack of emphasis by dentists on taking and reviewing a patient’s social history may stem from their dental school education, where students focus on completing clinical procedures as a pathway to graduation.…”

Teaching health promotion competencies in undergraduate dentistry training: A unique pedagogical approach

“…11,12 Authentic interactions with school children builds on theoretical health promotion concepts, creating the opportunity for dentistry students to expand their understanding of oral health challenges, particularly in priority groups. 9,12 An experiential learning approach is also used in the classroom, where students engage in role-play. This active learning technique can help motivate students, supports deeper understanding and assists students to retain health promotion knowledge.…”