Disparities in Access to Oral Health Care

Abstract

In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.

Keywords: dental services; disadvantaged populations; interventions to reduce disparities; life course approach; oral disease prevention; oral health care equity.

Figure 1

This conceptual model, factors that influence disparities in access to care and quality of health care services, by level, was created from the analysis of findings from systematic reviews of cardiovascular disease and cancer disparities (115). Figure adapted from Reference with permission.

Figure 2

This graphic of the life course perspective begins in infancy and moves through older adulthood, focusing on health behaviors at critical periods that foster oral and craniofacial health (15). Figure adapted from Reference with permission.