Social Determinants of Oral Health

The child, family, and community all influence the oral health outcomes of children.

  • Oral health inequities are largely influenced by community level rather than individual factors
  • Integrated approach of policy and individual influences promote the greatest impact on health inequities, including oral health
  • Health care teams have a critical role in promoting oral health equity for patients and communities. Primary care teams are well positioned to promote oral health during routine well child visits, but also medical-dental integration within the wider community.

Child level influences include:

  • Physical attributes, biologic and genetic characteristics
  • Health behavior and practices
  • Dental insurances and use of dental care

Family level influences include:

  • Family culture, function, and composition
  • Socioeconomic status, social supports, safety
  • Health behaviors, practices, and coping skills; parent health status

Community level influences include:

  • Social environment and social capital
  • Characteristics of the dental and health care systems
  • General culture and oral health environment
  • Physical environment and safety

References

Susan A. Fisher-Owens, SA Gansky, LJ Platt, et al. Influences on children's oral health: A conceptual model. Pediatrics 2007; 120(3): e510.

Patrick DL, Lee RS, Nucci M, Grembowski D, Jolles CZ, Milgrom P. BMC Oral Health. 2006; 6 Suppl 1:S4.

Watt RG, Sheiham A. Integrating the common risk factor approach into a social determinants framework. Community Dent Oral Epidemiol. 2012; 40: 289–296.

Social Determinants of Heatlh: A Quick Guide for Health Professionals. Julie Mikkonen and Dennis Raphael, 2012.

The triad was adapted from Keyes PH. Int Dent J. 1962;12: 443–464; and the concentric oval design was adapted from the National Committee on Vital and Health Statistics. Shaping a Health Statistics Vision for the 21st Century. Washington, DC: Department of Health and Human Services Data Council, Centers for Disease Control and Prevention, National Center for Health Statistics; 2002:viii.

Figure published in Pediatrics by: Fisher-Owens SA, Gansky SA, Platt LJ, et al. Influences on children's oral health: A conceptual model. Pediatrics. 2007;120(3); e510.

Figure above adapted from the following 2 sources, with secondary, explicit permission obtained for use in the Smiles for Life Curriculum:

  • Keyes, PH. Recent advances in dental research: bacteriology. (1962). Int Dent J; 12:443-464. Permission granted by Wiley Publication for use of the caries triad concept. Reference is: Keyes, P.H. Recent advances in dental research: bacteriology. Int Dent J 1962; 12:443-464. Reprinted with permission of John Wiley & Sons, Inc.
  • Concentric Oval Design adapted, with permission, from Shaping a Health Statistics Vision for the 21st Century. Figure 1. Influences on the Population's Health. Washington, DC: Department of Health and Human Services Data Council, Centers for Disease Control and Prevention, National Center for Health Statistics; 2002:viii.