Unheard Voices on Oral Health: Qualitative Research with Disadvantaged Communities

Objectives: Oral diseases disproportionately affect marginalised groups in society, who are often overlooked or excluded from research. This study aimed to engage with disadvantaged and vulnerable groups across high-and middle-income countries to explore experiences of oral health and views on oral health services.
Methods: Five disadvantaged groups were included: homeless adults (Brazil and Nigeria), informal female workers (India), Venezuelan migrants (Colombia), adults from urban ‘slum’ communities (Colombia), and adults from communities with socioeconomic disadvantage (UK and Nigeria). Individual interviews were conducted across five settings (Brazil n=15, Colombia n=41, India n=30, Nigeria n=18, UK n=17). Focus groups were held in two settings (Brazil n=2, UK n=1). Interviews and focus groups were recorded, transcribed, translated into English, and analysed using thematic analysis.
Results: Themes emerged in relation to how participants defined oral health, its perceived importance, and their experiences of oral disease and dental services. ‘Good’ oral health was generally defined across all settings in relation to having white, straight teeth, and the absence of caries or pain. Many participants described experiences of ‘DIY dentistry’ due to lack of access to oral health services and the negative impact of oral pain on work and family activities. Oral health was regarded as significant in relation to aesthetics, self-esteem, speaking and eating. Both positive and negative experiences of oral health services were reported. The use of traditional treatments for oral problems was prevalent across some settings, and the influence of peers, family and community in disease prevention and treatment was evident. Participants expressed opinions regarding improved access to local, affordable, quality dental services and community advocacy for oral health.

Conclusion:
Oral health matters to disadvantaged people globally. There is a need to engage with and involve communities in oral research to develop policies to promote oral health, provide access to appropriate services and reduce oral health inequalities.

Brief 1 sentence abstract summary:
A qualitative study which describes the experiences and opinions of marginalised groups on oral health from across the world.

Text for submission acknowledging funding of the study:
This study is funded by the NIHR Global Health Group on Oral Health (NIHR 132731)/ NIHR Global Health Research Groups. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care