Racial Inequalities in Oral Health

Abstract

Together with other social categories, race has been at the core of much scholarly work in the area of humanities and social sciences, as well as a host of applied disciplines. In dentistry, debates have ranged from the use of race as a criterion for the recommendation of specific dental procedures to a means of assessing inequalities in a variety of outcomes. What is missing in these previous discussions, though, is a broader understanding of race that transcends relations with genetic makeup and other individual-level characteristics. In this review, we provide readers with a critique of the existing knowledge on race and oral health by answering the following 3 guiding questions: (1) What concepts and ideas are connected with race in the field of dentistry? (2) What can be learned and what is absent from the existing literature on the topic? (3) How can we enhance research and policy on racial inequalities in oral health? Taken together, the reviewed studies rely either on biological distinctions between racial categories or on other individual characteristics that may underlie racial disparities in oral health. Amidst a range of individual-level factors, racial inequalities have often been attributed to lower socioeconomic status and "health-damaging" cultural traits, for instance, patterns of and reasons for dental visits, dietary habits, and oral hygiene behaviors. While this literature has been useful in documenting large and persistent racial gaps in oral health, wider sociohistorical processes, such as systemic racism, as well as their relationships with economic exploitation, social stigmatization, and political marginalization, have yet to be operationalized among studies on the topic. A nascent body of research has recently begun to address some of these factors, but limited attention to structural theories of racism means that many more studies are needed to effectively mitigate racial health differentials.

Oral diseases: a global public health challenge

“…[69][70][71] In a review of seven studies, Slade found the prevalence of dental pain ranged from 5-33% and to increased with child age, caries severity, and decreasing socio-economic status. People from LMIC and indigenous populations in high income countries, have a lifetime history of dental pain that generally exceeded 50% of children [72][73][74][75][76][77] Dental problems can result in lost time from school and to negatively impact on school performance possibly exacerbating social inequalities. 4,[78][79][80][81][82][83][84] Numerous studies show that untreated dental caries and associated oral problems substantially decrease quality of life for both the child, as well as their caregivers.…”

‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services

“…The institutional racism contributing to much of the participants’ reluctance to attend for dental care requires a whole of society shift [ 23 ]. Certainly, the recent Black Lives Matter movement has raised awareness of this, as has the increased profile of many prominent Indigenous Australian leaders.…”

“…Certainly, the recent Black Lives Matter movement has raised awareness of this, as has the increased profile of many prominent Indigenous Australian leaders. The role of racism in oral health inequalities has been documented at a global level [ 23 ]. Although there is limited evidence of successful initiatives to address this, there are some encouraging results from the general health arena in this space [ 24 ].…”

Fifteen‐year gap between oral health of blacks and whites in the USA

“…A recent literature review from field experts has come to similar conclusions: “racial health inequalities should be of primary concern for both policy makers and researchers” . However, the authors caution that much of the inequality can be attributed to the overrepresentation of racial minorities in lower income groups …”