Recent insights in social determinants of health (SDH) indicate that addressing these broad influences will positively affect health outcomes. Here I’ll explore the various social determinants impacting oral health, discuss health disparities, and provide actionable insights for dental professionals to integrate into their patient care plans.
Social determinants of health
According to the World Health Organization (WHO), “The social determinants of health (SDH) are the nonmedical factors that influence health outcomes.”1The circumstances in which people are born, grow, live, work, and age significantly impact health and well-being. Some examples of SDH are socioeconomic status, education level, employment, and access to health care.
Lower socioeconomic status is linked to a higher prevalence of dental caries and periodontal disease due to limited access to dental care and preventive services.2 In addition, financial constraints may lead to poor nutrition and unhealthy dietary habits, contributing to oral health issues.
Children from families with high SES have better oral health and are more likely to visit the dentist regularly than those from low SES backgrounds.2 Reports suggest that the presence of dental caries serves as a robust indicator of socioeconomic inequality in children and adults.
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Education
Higher education levels are linked to better oral health knowledge.3 Education can increase health literacy, enabling individuals to make informed decisions about their health. With a deeper understanding of oral health and the disease process, patients are more likely to adopt proper hygiene practices.
Employment and access to care
Stable employment with dental benefits facilitates regular dental visits, which results in early intervention for oral health problems. Additionally, unemployment or job insecurity stress can contribute to oral health issues. A 2020 study proved that having access to dental insurance through an employer increases the percentage of those who attend routine dental visits and improves overall oral health status.4 Lack of access to preventive care can contribute to avoidable oral health problems.
Gaining control over dental disease requires initiatives that prioritize social determinants as a foundational structure for health-enabling environments. Dental health care needs innovative models that allocate resources to population-based promotions that address social determinants. Until then, dental professionals can address SDHs by providing culturally competent care, engaging in community outreach, collaborating with other health-care professionals, and advocating for policy changes. Through these efforts, we can help reduce oral health inequities.
Addressing social determinants in dental hygiene practice
Screening and assessment
Dental professionals can use screening tools during patient assessments to identify social determinants that affect oral health. By gathering information about a patient’s socioeconomic background, living conditions, and health-care access, we can gain valuable insight into the barriers they might face in maintaining optimal oral health. This information leads to a personalized care plan that addresses each patient’s needs and circumstances.
Referral networks
Building strong partnerships with social service agencies and community organizations enables the dental team to refer patients to resources that address social determinants. These referrals may include financial assistance programs, housing support, and health-care access initiatives. Collaborating with other professionals in community-based organizations allows the dental team to create a holistic approach to patient care.
Culturally competent care
Cultural competency training is crucial to better understand the diversity and cultural backgrounds of patients. Embracing cultural sensitivity fosters trust between patients and the dental team, which leads to open communication and patient engagement. Awareness of cultural practices and beliefs helps deliver respectful and responsible care for each patient’s unique needs.
Individualized care plans
Tailoring treatment plans to the patient’s financial circumstances, time constraints, and oral health needs is essential for patient-centered care. Involving patients in the decision-making process empowers them to take an active role in managing their oral health. This approach increases patient compliance and improves treatment outcomes.
Community outreach
Engaging in community-based initiatives allows the dental team to engage with underserved populations to promote oral health awareness, preventive care, and access to dental services. By actively participating in community events and outreach programs, we can contribute to improving oral health outcomes beyond the clinical setting.
Advocacy
By engaging in local, state, and national advocacy, we can bring attention to the impact of social determinants on oral health disparities. We can work with policymakers and legislators to promote policies that increase access to dental care, expand dental coverage for vulnerable populations, and prioritize preventive oral health initiatives to significantly improve health outcomes.
It’s vital to recognize the significance of social determinants of health in the dental practice. These determinants must be properly addressed before the dental disease burden can fully resolve. By addressing these determinants through personalized care plans, patient education, community outreach, and advocacy efforts, dental professionals can contribute to a more equitable and inclusive approach to health care. Together, let us work toward a future where oral health equity is a reality for everyone.
References
- Social determinants of health. World Health Organization. 2023. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
- Verlinden DA, Reijneveld SA, Lanting CI, Wouwe JP, Schuller AA. Socioeconomic inequality in oral health in childhood to young adulthood, despite full dental coverage. Eur J Oral Sci. 2019;127(3):248-253. doi:10.1111/eos.12609
- Marquez-Arrico C, Almerich-Silla J, Montiel-Company J. Oral health knowledge in relation to educational level in an adult population in Spain. J Clin Exp Dent. 2019;11(12):e1143-1150. doi:10.4317/jced.56411
- Zivkovic N, Aldossri M, Gomaa N, Farmer JW, Singhal S, Quiñonez C, Ravaghi V. Providing dental insurance can positively impact oral health outcomes in Ontario. BMC Health Serv Res. 2020;20(1). doi:10.1186/s12913-020-4967-3
