Community Dental Health

cover art

Cover Date:
March 2019
Print ISSN:
0265 539X
Electronic ISSN:

Interventions to reduce socio-economic inequalities in dental service utilisation – a systematic review


Objective: A gradient exists where people with lower socio-economic status (SES) use dental services less regularly than others. Evidence
suggests these SES differences may contribute to inequalities in oral health. A variety of approaches have been tried to increase regular
dental service use, although it is possible that some are ineffective or may even widen SES inequalities. We aimed to undertake a systematic review of interventions to reduce SES differences in dental visiting. Basic research design: Interventions limited to those influencing
dental service use by adults. Any type of experimental design, investigating interventions aiming to reduce SES inequalities in dental
service use, was included. Primary outcome was a measure of dental utilisation. Results: Electronic search of 8 databases, with citation
snowballing, identified 14,396 titles and abstracts. Paper eligibility screening identified 63 full papers, of which 6 met the inclusion criteria.
All included studies were conducted in the United States. Of these, three were targeted to parents, and two towards pregnant women.
Two studies incorporated mailing postcards as (at least) one component of the intervention, although results were mixed. Another three
studies included scheduling dental appointments as part of a multi-component approach, again with mixed results. The remaining study,
involving community health advisors undertaking activities aimed at raising community awareness, found no significant intervention effect.
Conclusions: Evidence in this area is limited and results are mixed. More work is needed to investigate the effectiveness of interventions
to reduce SES inequalities, especially in different healthcare systems and involving a wider participant range.

Keywords: Dental visiting, inequalities, dental practice, systematic review, socio-economic status

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Raison H, Harris RV

Articles from this issue

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  1. Editorial:‘No simple solutions, no single ingredient’: Systemsorientated approaches for addressing Wicked Problems in population oral health
  2. 3
  3. 4

  1. Dental Public Health in Action: The use of the NICE ten step model to conduct an oral health needs assessment in South Yorkshire and Bassetlaw
  2. 5
  3. 8

  1. Caries-preventive efficacy of a supervised school toothbrushing programme in Northland, New Zealand
  2. 9
  3. 16

  1. Socioeconomic Variation in the association between Malocclusion and Oral Health Related Quality of Life
  2. 17
  3. 21

  1. Low rates of dental attendance by the age of one and inequality between local government administrative areas in England
  2. 22
  3. 26

  1. The relationship between body mass index and oral health status among Saudi adults: a cross-sectional study
  2. 27
  3. 32

  1. The acceptability of fluoride varnish and fissure sealant treatments in children aged 6-9 delivered in a school setting
  2. 33
  3. 38

  1. Interventions to reduce socio-economic inequalities in dental service utilisation – a systematic review
  2. 39
  3. 45

  1. Embarrassing realities: The portrayal of dentistry in reality tv ‘dentertainment’
  2. 46
  3. 54

  1. Systems science and oral health: Implications for Dental Public Health?
  2. 55
  3. 62

  1. The Boundaries between Caries and Periodontal Diseases. What are the Implications for Education in Dental Public Health? Proceedings of EADPH/SESPO Pre-Congress Workshop held on Wednesday, 17 October 2018 at The Centro Cultural Sa Nostra Congress Cen
  2. 63
  3. 86