Reflections on oral health inequalities: Theories, pathways and next steps for research priorities

Abstract

Health inequalities have not decreased over the last decades and for some outcomes have even increased, with disadvantaged groups in contemporary societies still enduring higher burdens of mortality and morbidity, including oral diseases. 1,2 These stark inequalities in health most often take the pattern of a social gradient, whereby each lower socioeconomic position group has a higher health burden than the immediately less deprived group. 3 These social gradients are linked to structural factors like policies of economic liberalization, changes in labour markets and an austerity approach to social policies. 4,5 Moreover, the COVID-19 pandemic has both magnified previously existing inequalities and created new ones in what has been called the syndemic of COVID-19, non-communicable diseases (NCDs) and the social determinants of health. 6 The pandemic has exacerbated access barriers with the more disadvantaged population

Behavioural and cognitive‐behavioural theories in oral health research: Current state and future directions

“…Across multiple domains, theory has been energized in the behavioural and social oral health sciences, as demonstrated in a number of articles in this special issue 19,59–62 . As shown in the various figures presented here, existing behavioural and cognitive‐behavioural theories and models continue to be utilized in oral health research.…”

“…Across multiple domains, theory has been energized in the behavioural and social oral health sciences, as demonstrated in a number of articles in this special issue. 19,[59][60][61][62] As shown in the various figures presented here, existing behavioural and cognitivebehavioural theories and models continue to be utilized in oral health research. Conceptualizations that are newer (or new to oral health research), such as Salutogenesis and the BCW, COM-B and TDW are energizing the research effort.…”

“…Individual difference factors, not just the average or typical behaviours of groups, must be incorporated into our theories and models. Moreover, oral and other health and social inequalities and inequities (see Tsakos et al 59 ) are evidence of the need for inclusion of cultural, racial, ethnic, religious, socioeconomic and other factors that lead to marginalization and oppression of societal groups (see Fleming et al 60 ). There is a crucial need to focus on systemic factors that lead to health outcome differences among groups.…”

Cultural competency in dental education: developing a tool for assessment and inclusion

“…For example, people from lower socio-economic groups live in communities that do not have access to fluoridated water, school sealant programs, and lack of public transportation which makes it difficult to make their dental appointments. 16 Cultural humility is a humble and respectful attitude toward individuals of other cultures that allows health professionals to challenge their own biases, realize they cannot possibly know everything about others cultures, and approach learning about other cultures as a lifelong goal and process. 17 Thus, a dentist who encounters a patient who is a non-native English speaker and who observes certain food traditions will try to learn about this tradition, the meaning it holds for the patient, how it affects their oral/health and communicate with them about it.…”

Sub-Optimal Oral Health, Multimorbidity and Access to Dental Care

“…Importantly, there are common risk factors to oral and related chronic conditions which lie within the social and living environments including poor diet, smoking, high sugar consumption and psychosocial stress (Gomaa, 2022;Sheiham & Watt, 2000), all of which concentrate in less affluent individuals, including underserved and marginalized populations (Fleming et al, 2023;Tsakos et al, 2023). These shared common risk factors point towards the need for innovative medical and dental integration models.…”