Theoretical explanations for social inequalities in oral health

Abstract

Social inequalities in health and oral health continue to present a major challenge to public health. Progress towards the development of interventions to reduce health inequalities is currently being hampered by an incomplete understanding of the causes of inequalities in health. This paper aims to provide oral health researchers with an overview of four current explanations for inequalities in oral health and to suggest further areas of research needed to advance our understanding of the causes of social inequalities in oral health.

Epidemiology of dental caries: when structure and context matter

“…23 Studies in the United Kingdom have shown that water fluoridation may reduce social inequalities in caries experience, in both deciduous and permanent teeth. 24,25 The notion that water fluoridation is an environmental variable that would not be affected by the position of individuals in the social structure or by income and educational levels 26 would require that it be distributed equally, without any important variation related to consumption sources or fluid intake frequency in different population groups; however, this cannot always be ensured. 27 The implementation of public policies may vary in extent and depth according to the structure of each country.…”

“…A social and cultural perspective regarding behavioral decision-making is still largely absent from the health inequalities literature. 26 A study was conducted on dental caries that investigated the influence of family socioeconomic trajectories and associated behaviors in Brazilians aged 15 years old, under the life course theory. It showed that poverty in early life has an effect on dental caries, oral behaviors and use of dental services later on, mitigated only partially by upward social mobility between childhood and adolescence.…”

Income-related Inequalities in Dental Service Utilization by Europeans Aged 50+

“…While there is disagreement about the exact explanation for such a socio-economic gradient in oral health (Petersen, 2005;Brunner and Marmot, 2006;Sisson, 2007), it has frequently been suggested that dental attendance patterns are one pathway through which differences in oral health may emerge. In particular, regular and frequent dental attendance has been shown to be associated with better oral health and to be more common among individuals with higher socio-economic status, and vice versa (Unell et al, 1999;McGrath and Bedi, 2001;Petersen et al, 2004;Dye and Selwitz, 2005;Krustrup and Petersen, 2006;Sanders et al, 2006;Donaldson et al, 2008;Pavi et al, 2010).…”

Faglige udfordringer for fremtidens tandpleje, set i et samfundsodontologisk perspektiv

“…Men hensyn til forekomst og udvikling af caries er der ofte tale om underliggende samfundsstrukturer og årsager, som ikke lader sig aendre uden videre (20). Det er foreslået, at man i det forebyggende arbejde fokuserer mere på de geografiske områder, hvor tandsundhedstilstanden er ringe fremfor at fokusere på familiernes sociale og kulturelle status (21).…”