Getting to the Bottom of Oral Health Inequities

It’s been well established that oral health significantly impacts overall health. In fact, poor oral hygiene is linked to myriad conditions including cardiovascular disease, cognitive decline, and diabetes. And its effects can be far reaching.

Noting the potential lifelong impacts of poor oral health, Brenda Heaton, PhD, associate dean for research at the University of Utah School of Dentistry, says, “What’s especially infuriating is that the occurrence and impacts of poor oral health are largely preventable. It has a lot to do with whether or not one can access and effectively utilize dental care.”¹

But if oral health is so integral to overall health, why do issues negating it remain so prevalent? Thanks to a Sustaining Outstanding Achievements in Research (SOAR) Award, Heaton is determined to find out.¹

Multilevel Problem

Heaton is spearheading an 8-year, $8 million research project to explore the root causes of oral health inequities. Funded by the National Institute of Dental and Craniofacial Research, the research will focus on contributing factors at various levels. At the population level, the project will explore how factors, including Medicaid oral health policies and dental provider location, affect access to dental care. At the patient level, the researchers will examine reasons for fear and anxiety in relation to dental visits, which can interfere with needed care.

A primary interest of Heaton’s involves the provider level and how patient-provider interactions and clinical decision-making affect care, which she believes has been understudied. It is Heaton’s contention that through learning how these various factors interact and contribute to oral health disparities, researchers can pinpoint the most effective interventions.¹

Complex Interactions

According to the United States Centers for Disease Control and Prevention, lack of access to oral health services is part of the reason for health disparities. As of 2024, about 57 million Americans live in a dental health professional shortage area. About 67% of these areas are in rural communities.²

When people lack access to dental care, they may end up needing complicated dental treatments such as tooth extractions. These stressful experiences, especially if not well understood by the patient or explained by the provider, could make them more likely to avoid oral health care due to anxiety, even if their access to dental care improves.¹

Heaton plans to develop computer simulation models to study these interactions and how various factors influence each other. She and her collaborators hope to generate a more comprehensive view of how to design and target interventions to address oral health inequities.

Streamlined Process

University of Utah Health stores its medical and dental health records in the same system, unlike many others. This will allow researchers to easily find connections to build a more complete picture of a person’s overall health. “We have this opportunity for a fully integrated clinical database, an opportunity that just doesn’t exist in a lot of systems,” Heaton says.¹

Appreciating the flexibility the 8-year grant affords to develop new research approaches and build on earlier stages of work, Heaton says she also looks forward training and mentoring more researchers as part of the project. “To be able to contribute to a pipeline of trainees who are dedicated to population oral health and focused on disparities is especially exciting,” she says.¹

References

1. Friesen S. Getting to the root of the problem: $8M in funds investigation into oral health disparities.
2. United States Centers for Disease Control and Prevention. Health Disparities in Oral Health.