From Barriers to Solutions: A Community Network Approach to Equitable Oral Healthcare Access

INTRODUCTION: Across Europe, oral health is increasingly recognized as a public health priority. Still, structural, financial, and social barriers disproportionately affect people in vulnerable circumstances. OBJECTIVE: Within the EU-funded DELIVER project, this study aimed to (1) identify which barriers to oral healthcare manifest across urban contexts, and (2) explore how community networks including citizens, healthcare professionals, social workers, policy makers, and other local stakeholders can contribute to developing local solutions related to improving quality of oral healthcare for citizens in vulnerable circumstances. METHODS: A participatory action research design, guided by the Community Health Improvement Process, was used. Participants included citizens with lived experience of poverty or social exclusion, oral healthcare professionals, social workers, and policymakers. Data collection methods included semi-structured interviews, focus groups, co-creation meetings, and creative workshops. Data were analyzed using inductive thematic analysis. RESULTS: A total of 64 participants contributed to 21 interviews, 7 focus groups, and 4 co-creation meetings. Seven key barriers were identified: high treatment costs, limited insurance coverage, low oral health literacy, emotional and psychological factors (e.g., shame and fear), competing life priorities, limited support from professional organizations, and poor communication between social and oral healthcare services. Proposed solutions included walk-in consultations in community settings, buddy systems, improved support for navigating insurance, stronger integration of dental and social care, and oral health promotion through trusted local networks. CONCLUSION: Community-network approaches can substantially reduce inequalities in access to oral healthcare. Engaging citizens as co-creators enables inclusive and needs-based solutions and improvements. This study offers a promising model for improving oral healthcare accessibility by systematically identifying barriers and addressing them through community-based collaboration.