28 | wileyonlinelibrary.com/journal/cdoe Community Dent Oral Epidemiol. 2023;51:28–35.
1 | INTRODUCTION
An individual's ability to access oral health care and maintain healthy
teeth and gums is as much a function of one's ability to pay for care
as it is dependent upon where one lives. Whether one is in the U.S.
south, the global south or a rural community, oral health is a func-
tion of both place and privilege. While the history and conditions
of countries may vary, health inequity is not driven by biology and
genetics but by systems, structures and policies that support and
entrench hierarchies among social groups.
People with oral health needs are often located in cities and
areas where oral health providers maintain a profitable business for
their practice.
1
The ability of an individual and population to have
optimal oral health is thus conditioned upon where people live, the
available resources, and how easy or difficult it is to make healthy
choices.
2
If access to dental providers is determined by one's ability
Received: 13 January 2022
|
Revised: 7 November 2022
|
Accepted: 16 November 2022
DOI: 10.1111/cdoe.12822
ORIGINAL ARTICLE
Conceptualizing inequities and oppression in oral health
research
Eleanor Fleming
1
| João L. Bastos
2
| Lisa Jamieson
3
| Roger K. Celeste
4
|
Sarah E. Raskin
5
| Noha Gomaa
6
| Colman McGrath
7
| Tamanna Tiwari
8
Eleanor Fleming and João Luiz Bastos are co-first authors.
1
University of Maryland School of
Dentistry, Baltimore, USA
2
Graduate Program in Public Health,
Federal University of Santa Catarina,
Florianópolis, Brazil
3
Australian Research Centre for
Population Oral Health, The University of
Adelaide, Adelaide, Australia
4
Department of Preventive and Social
Dentistry, Federal University of Rio
Grande do Sul, Porto Alegre, Brazil
5
iCubed Initiative Oral Health Core,
Douglas Wilder School of Government and
Public Affairs, Virginia Commonwealth
University, Virginia, USA
6
Oral Diagnostic Sciences, Schulich School
of Medicine and Dentistry, Western
University, London, Canada
7
Applied Oral Sciences & Community
Dental Care, University of Hong Kong,
Hong Kong, Hong Kong
8
School of Dental Medicine, University
of Colorado Anschutz Medical Campus,
Aurora, USA
Correspondence
Tamanna Tiwari, School of Dental
Medicine, University of Colorado
Anschutz Medical Campus, 13065 East
17th Avenue, Aurora, CO 80045, USA.
Email: tamanna.tiwari@cuanschutz.edu
Abstract
Major sociohistorical processes have profound effects on oral health, with impacts
experienced through structural oppression manifested in policies and practices
across the lifespan. Structural oppression drives oral health inequities and impacts
population-level oral health. In this global perspective paper, we challenge old as-
sumptions about oral health inequities, address misleading conceptualizations in their
description and operation and reframe oral health through the lens of intersecting
systems of oppression. Furthermore, we emphasize the need for oral health research-
ers to explore causal pathways through which oppression harms oral health and en-
gage in social science concepts to understand the root causes of oral health inequities
fully. Finally, we call on policymakers, dental scholars and decision makers to consider
health equity in all policies and to take a systems-oriented approach to effectively
address oral health inequities.
KEYWORDS
access to oral health, intersectionality, oppression, oral health inequities
© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
16000528, 2023, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/cdoe.12822 by CAPES, Wiley Online Library on [19/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License