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

2023/02/01 by Georgios Tsakos, Richard G. Watt, Carol C. Guarnizo‐Herreño +1 · 1 citation
Dentistry · Health Professions · Social Sciences · #Dental Health and Care Utilization #Food Security and Health in Diverse Populations #Health disparities and outcomes

paper · pdf · doi:10.1111/cdoe.12830

openalex publication_date 2023/02/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/26

Abstract

Health inequalities, including those in oral health, are a critical problem of social injustice worldwide, while the COVID-19 pandemic has magnified previously existing inequalities and created new ones. This commentary offers a summary of the main frameworks used in the literature of oral health inequalities, reviews the evidence and discusses the potential role of different pathways/mechanisms to explain inequalities. Research in this area needs now to move from documenting oral health inequalities, towards explaining them, understanding the complex mechanisms underlying their production and reproduction and looking at interventions to tackle them. In particular, the importance of interdisciplinary theory-driven research, intersectionality frameworks and the use of the best available analytical methodologies including qualitative research is discussed. Further research on understanding the role of structural determinants on creating and shaping inequalities in oral health is needed, such as a focus on political economy analysis. The co-design of interventions to reduce oral health inequalities is an area of priority and can highlight the critical role of context and inform decision-making. The evaluation of such interventions needs to consider their public health impact and employ the wider range of methodological tools available rather than focus entirely on the traditional approach, based primarily on randomized controlled trials. Civil society engagement and various advocacy strategies are also necessary to make progress in the field.

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