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Oral Health As A Social Justice Issue: What Does It Mean?  

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Despite being largely preventable, equal access to oral health disease is under-prioritised by healthcare providers, governments and regulators alike. This disparity of care reflects unequal opportunities to be healthy, disadvantaging already disadvantaged groups. 

In a time with the most advanced medicine to date (including quality dentistry), the unavailability of equal dental care appears unjust. The real issue for many communities is access; change is slow, but great strides are being made across the sector to improve access for all. 

Increased equity in oral healthcare is already improving outcomes significantly, yet as with any social justice issue, it requires passionate people to drive change. 

   Change, however, is slow. The result is that far too many people live with intrusive, painful and damaging conditions. According to the 2023 WHO Global Oral Health Status Report, around 2 billion people live with untreated dental caries, making it the most prevalent condition among all diseases worldwide . These issues could be fixed, often by simple procedures.

The knock-on effects of poor oral health can not be understated, affecting: 

  • Work/Productivity. 
  • Focus/alertness
  • Sleep ( often your partners)
  • Straining relationships
  • Decreasing quality of life

So many of us know the pain associated with weeks of toothache, the long waits for relatively short procedures and the costs associated. The 1978 WHO declaration classifies primary health care as a fundamental human right, yet so many cannot access good quality healthcare. 

Positive outcomes for patients shouldn’t be few and far between; dentists, nurses and specialists should be able to focus their energy and expertise on patients, not politics. 

A key strategy for improvement is through training. New thinkers must approach the field of oral health with a refreshed lens. So, whether you are already working in the healthcare sector, are a passionate advocate for social reforms or are about to start a master’s degree online, consider the role your unique skillset could have in affecting real change. 

Care Models and Barriers to Access 

The most significant barriers to entry are the usual suspects: financial difficulty, disability, distance from clinics and a lack of information regarding the importance of oral health. These constraints, paired with the fact that many of the world’s most celebrated public health systems fall short of subsidising dentistry, drive disparity:

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  • Under the United Kingdom’s NHS, dentistry is only partially funded for adults 
  • In Australia and New Zealand, basic oral health services are only funded for those under 18 and some adults
  • In the States, access to affordable oral health is rare, with charities and federally funded community health centres taking up the slack. 

Due to these barriers, alongside care models in many States, there has been a tendency to focus on treatment instead of prevention. 

After all, when large portions of the population can not afford regular check-ups, patients only visit clinics when issues arise. The false economy of this approach means patients often require more complex procedures that could be prevented through early detection, driving up costs for everyone involved.  

Improving Outcomes and Innovating Equity

Early Detection 

  • Surveys such as an Australian report citing 31% of adults delayed or avoided visits due to cost show the scale of the issue.
  • In financially challenged communities, oral health is given low priority; understandably, when one is struggling to make rent and pay the bills, putting up with toothache is often the most reasonable solution.
  • If communities have access to bi-annual or even annual check-ups, the incidents of large procedures can be decreased as issues like gum disease and cavities are quickly fixed.

Accessibility 

  • The rising trend, post-COVID-19 of  Telehealth and video appointments, is a valuable tool where physical access is challenged; many issues can be diagnosed, and the level of care required can be ascertained without wasting time for patients and dentists alike.
  • Mobile dentistry is a great option. Clinics on wheels can pull up outside the local school, community centre or wherever is most needed and offer check-ups and simple procedures, directly targeting those in need. 

Education 

  • The dangers for children are worrying, from our sugar-rich foods to the rise in electronic cigarettes and the age-old gum diseases associated with alcohol and cigarettes. Parents and educators must pay careful attention to instilling positive habits. 

If the next generation of thinkers can lobby, rally and educate on a State and Federal level, healthcare systems will begin to change. As coverage improves, so does equity and economies of scale dictate costs will fall as volume increases. Small targeted programs are a start, but many fall through the cracks. Consider what difference you can make, pick up new skills to solve this complex issue, or use your existing influence to bring it to the forefront. 

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