Oral health in vulnerable populations: challenges, strategies and evidence from the literature

Main Article Content

Milena Duarte Moreira
https://orcid.org/0009-0002-2952-7474
Janaina Paiva Curi
https://orcid.org/0000-0003-0819-7787

Abstract

Introduction: Oral health is an essential component of general health and well-being, playing a crucial role in the quality of life of individuals. However, social, economic and cultural inequalities often result in unequal access to dental care, especially in vulnerable populations.


Objective: To identify in the existing literature databases on oral health promotion initiatives in vulnerable populations and to identify effective strategies and persistent challenges.


Method: We used 16 articles in this review, studies on oral health in vulnerable populations, such as the elderly, migrants, and children.


Results: The discussion about access to dental care for vulnerable populations reveals a complex scenario, in which several social, economic, cultural, and structural barriers compromise equity in access to oral health care.


Conclusion: The promotion of oral health in vulnerable populations requires an intersectoral, equitable, and communitycentered approach, with policies supported by scientific evidence and oriented towards social inclusion. Investing in integrated strategies that consider the specific contexts of these populations is essential for overcoming inequities and strengthening oral health as an integral part of the right to health.

Article Details

Section

Review Article

References

Katz AS, Hardy BJ, Firestone M, Lofters A, Morton-Ninomiya ME. Vagueness, power and public health: use of ‘vulnerable‘ in public health literature. Critical Public Health. 2020;30(5):601–11. https://doi.org/10.1080/09581596.2019.1656800

Clark B, Preto N. Exploring the concept of vulnerability in health care. CMAJ. 2018;190(11):E308-E309. https://doi.org/10.1503/cmaj.180242

Fdi World Dental Federation. Access to oral healthcare for vulnerable and underserved populations. Int Dent J. 2020;70(1):15-16. https://doi.org/10.1111/idj.12556

Luchenski S, Maguire N, Aldridge RW, Hayward A, Story A, Perri P, et al. What works in inclusion health: overview of effective interventions for marginalised and excluded populations. Lancet. 2018;391(10117):266-80. https://doi.org/10.1016/s0140-6736(17)31959-1

Freeman R, Doughty J, Macdonald ME, Muirhead V. Inclusion oral health: Advancing a theoretical framework for policy, research and practice. Community Dent Oral Epidemiol. 2020;48(1):1-6. https://doi.org/10.1111/cdoe.12500

De Visschere L, Janssens B, De Reu G, Duyck J, Vanobbergen J. An oral health survey of vulnerable older people in Belgium. Clin Oral Investig. 2016;20(8):1903-12. https://doi.org/10.1007/s00784-015-1652-8

Watt RG, Venturelli R, Daly B. Understanding and tackling oral health inequalities in vulnerable adult populations: from the margins to the mainstream. Br Dent J. 2019;227(1):49-54. https://doi.org/10.1038/s41415-019-0472-7

Velázquez-Cayón RT, Contreras-Madrid AI, Parra-Rojas S, Pérez-Jorge D. Oral Health and Pathologies in Migrants and Vulnerable Population and Their Social Impact: The Good Practices of the Intervention Model of a University Dental Clinic. Int J Environ Res Public Health. 2022;20(1):353. https://doi.org/10.3390/ijerph20010353

Macdonald ME, Muirhead V, Doughty J, Freeman R. Critically engaging vulnerability: Rethinking oral health with vulnerabilized populations. Community Dent Oral Epidemiol. 2022;50(6):469-75. https://doi.org/10.1111/cdoe.12703

Fernández-Bonet J. La importancia de la aproximación a los grupos vulnerables en materia de salud bucodental / The importance of approaching vulnerable groups in oral health. Aten. prim. 2023:55:102665.

Wisner B. Vulnerability as Concept, Model, Metric, and Tool. Nat Hazard Sci. 2016. https://doi.org/10.1093/acrefore/9780199389407.013.25

Patel R, Robertson C, Gallagher JE. Collaborating for oral health in support of vulnerable older people: co-production of oral health training in care homes. J Public Health (Oxf). 2019;41(1):164-9. https://doi.org/10.1093/pubmed/fdx162

Mejía R, Ramirez DAG, Garcés CNC, Munoz LFR. Dental health for Popayán´s vulnerable and displaced communities that live in poverty conditions. Rev. cuba. salud pública. 2019:45(3):e1289.

Martignon S, Guarnizo-Herreño CC, Franco-Cortés, García-Zapata LM, Ochoa-Acosta EM, Restrrepo-Perez LF, et al. Socioeconomic inequalities in early childhood caries: evidence from vulnerable populations in Colombia. Braz. oral. res. 2024:38:e126. https://doi.org/10.1590/1807-3107bor-2024.vol38.0126

World Health Organization. WHO Implementation manual. Geneva: World Health Organization; 2019.

Pitts NB. Early childhood caries: IAPD Bangkok Declaration. Int J Paediatr Dent. 2019:29:384-6. https://doi.org/10.1111/ipd.12490