Social Justice and Oral Health

Fighting for Justice in Oral Healthcare

Social justice is the pursuit of equity and human rights for all individuals, particularly those who have been historically marginalized. It challenges systemic inequalities—whether rooted in race, gender, income, or access to resources—and strives to create a society where everyone, regardless of their background, has the opportunity to thrive. In healthcare, social justice means dismantling the barriers that prevent people from accessing the care they need to live healthy, fulfilling lives.

Dental professionals witness firsthand the disparities in access to care and how these inequalities affect our patients' well-being. Behind the statistics and policies are real people—families, children, and individuals—whose lives are shaped by the care they receive or do not receive. These stories highlight the urgent need for change in our oral healthcare system.

Let me share a few of these stories, illustrating not only the challenges many face in accessing care but also the important role dental hygienists can play in breaking down the barriers standing in their way. These stories remind us why social justice must be at the core of our practice.

• A Child in Pain with No Access to Care

I work in a school-based dental program. Last year, a 9-year-old student came to me crying because his tooth hurt so badly he couldn’t eat or sleep. His mother had taken him to the ER twice, but they only gave him pain medication. She couldn’t afford a dentist, and no Medicaid providers nearby were accepting new patients. It took us three months to get him treated. By then, he had already missed so much school. Why is this still happening in 2024?

This child’s story is not isolated. It reflects a broader issue: many children, especially in underserved communities, do not receive timely care due to a lack of affordable dental services. This impacts their health, education, and future. Dental hygienists are uniquely positioned to promote policies that enhance access through advocacy or by working in school-based programs to ensure no child is left behind.

• The Working Parent Who Can’t Afford to Take Time Off

I had a patient who worked two minimum-wage jobs and didn’t have paid time off. She needed a gum treatment and a filling, but every appointment meant losing wages. She kept delaying care, and by the time she finally came in, she needed an extraction. She told me, ‘I can’t afford to be healthy.’ Why should people have to choose between their paycheck and their health?

For many, taking time off from work to visit the dentist is a luxury they can’t afford. This reality leads to delayed care, worsened conditions, and higher costs in the long run. Dental hygienists can advocate for improved work policies, greater access to care, and educational programs centered on prevention.

• Racial Disparities in Dental Treatment

A Black woman experiencing gum pain and swelling for months finally saw a dentist, only to be quickly told she needed multiple extractions—without any discussion of options to save her teeth. She felt dismissed. Seeking a second opinion, she learned her teeth could have been treated without extractions. Now, she avoids dental offices altogether because she doesn’t feel heard. Why should patients have to question whether they’re receiving the same quality of care as everyone else?

Racial disparities in healthcare, including dental care, stem from systemic biases. This patient’s experience reflects a troubling pattern—marginalized communities are often subjected to rushed treatment or lower-quality care. Dental hygienists play an essential role in closing this gap by building trust, advocating for fair treatment, and ensuring every patient receives the compassionate, high-quality care they deserve.

• The LGBTQIA+ Patient Who Feared Discrimination

A transgender patient told me they avoided the dentist for years because they'd been misgendered and treated poorly in medical settings before. When they finally came in, they had severe gum disease that could have been prevented. They said, ‘I just didn’t want to deal with judgment again.’ Access isn’t just about cost—it’s also about feeling safe. Why should patients have to fear judgment when seeking essential care?

For some patients, access to dental care involves more than just affordability. Feeling respected and safe is critical. Transgender individuals often face discrimination in healthcare settings, leading to care avoidance. Dental hygienists can foster an inclusive, nonjudgmental environment, ensuring every patient feels valued.

• The Senior Who Went Without Care

A senior patient of mine had not seen a dentist in years due to a combination of low income and no dental insurance. By the time she came to us, she was dealing with severe tooth decay and gum disease. She said, ‘I’ve been living with this for so long. I just didn’t know where to turn.’ She was overwhelmed by the cost of treatment, and I could see the frustration in her eyes as she faced years of dental neglect. Why should seniors have to suffer from preventable dental issues?

Many seniors face barriers to dental care, resulting in preventable and complex conditions. Dental hygienists can make a difference by advocating for better coverage for older adults and by providing care in long-term care facilities or assisted living communities, where access is often limited.

These stories stress the need to address systemic barriers in oral health. Social justice in dentistry involves advocating for policies that increase equitable access to care and creating environments where every patient feels heard, safe, and respected.

Dental hygienists are key advocates in this movement. We can make a lasting impact by promoting prevention, education, and noninvasive care. Whether expanding access, tackling racial disparities, or creating inclusive spaces, we have the power to drive change in oral health. Let’s work to ensure that oral health is a fundamental right, not a privilege, for all!

Until I write again,

In gratitude,

Shavonne R. Healy, MSDH, RDH

CEO, A Higher Learning LLC