Social determinants of oral health inequalities: implications for action

For over 30 years, the WHO has been advocating an integrated approach in chronic disease prevention. The concept of the common risk factor approach (CRFA) highlighted shared risk factors for chronic conditions including oral diseases has provided the basis for closer integration of oral and general health promotion activities. Although considerable progress has been undoubtedly made in combating the isolation and compartmentalization of oral health, this paper will argue that future action on tackling oral health inequalities requires a reorientation of oral health policy away from a fixation on changing oral health behaviours to instead action on the common social determinants of oral health inequalities. The narrow and restricted interpretation of the CRFA is a serious threat to developing effective action to address oral health inequalities. Based upon the WHO conceptual framework on the social determinants of health inequalities, an overview will be presented of a range of actions that could be implemented to tackle the social gradients in oral health outcomes.