Vaishampayan Pranav, Beniwal Jaskaran Singh, Wilk Piotr, McLean Sarah, Jessani Abbas
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Department of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Front Oral Health. 2025 Mar 12;6:1521753. doi: 10.3389/froh.2025.1521753. eCollection 2025.
Barriers limiting access to oral health significantly impact dental service utilization among socially marginalized youth, often resulting in unmet needs and poor oral health outcomes. Identifying and understanding these barriers is critical to inform the development of strategies to enhance oral healthcare access for this vulnerable population. This review examines the barriers restricting access to oral healthcare and unmet dental needs among socially marginalized youth worldwide, offering insight to guide the development of targeted interventions.
A comprehensive search was performed across electronic databases, including Embase, MEDLINE (Ovid), Scopus, and the Cochrane Library. Two independent reviewers screened all primary studies, irrespective of publication year, to identify relevant research on barriers to care and unmet oral health needs among socially marginalized youth. Primary studies addressing barriers to oral healthcare access and unmet needs were included, with no restrictions on publication date. Studies published in languages other than English were excluded. Any discrepancies identified during the screening process were resolved through consensus. The CLARITY tool was utilized to evaluate the risk of bias in the included studies.
Of the 484 studies identified, six quantitative and one qualitative study met the inclusion criteria. The review identified multiple barriers such as financial constraints, structural impediments, and psychological factors that inhibit access to dental care facilities among socially marginalized youth. Three studies were conducted in the United States, two in Australia, and one each in the United Kingdom and Kenya. Among the identified barriers, four studies reported financial constraints and structural and logistical challenges, respectively while one study reported psychological barriers to dental care. A high prevalence of unmet needs such as dental caries and periodontal diseases, was observed within this demographic. The unmet dental needs identified in the included studies encompassed dental caries ( = 3), missing teeth ( = 2), periodontal diseases ( = 1), tooth pain ( = 1), and dental infections ( = 1). However, small sample sizes and lacking in robust study design limit the findings' generalizability, emphasizing the need for more diverse studies on oral health outcomes in socially marginalized youth.
This scoping review identified critical research gaps in regards to access to oral health and dental service utilization among socially marginalized youth. Oral health initiatives are warranted to reduce oral health inequalities among socially marginalized youth.
限制获得口腔健康服务的障碍对社会边缘化青年的牙科服务利用产生了重大影响,常常导致需求未得到满足以及口腔健康状况不佳。识别并理解这些障碍对于制定策略以改善这一弱势群体获得口腔医疗保健的机会至关重要。本综述考察了全球范围内限制社会边缘化青年获得口腔医疗保健服务及未满足的牙科需求的障碍,为制定有针对性的干预措施提供指导见解。
在包括Embase、MEDLINE(Ovid)、Scopus和Cochrane图书馆在内的电子数据库中进行了全面检索。两名独立评审员筛选了所有的原始研究,无论其发表年份,以确定关于社会边缘化青年获得医疗保健的障碍以及未满足的口腔健康需求的相关研究。纳入了涉及口腔医疗保健服务获取障碍和未满足需求的原始研究,对发表日期没有限制。排除了非英文发表的研究。在筛选过程中发现的任何差异均通过协商解决。使用CLARITY工具评估纳入研究中的偏倚风险。
在识别出的484项研究中,六项定量研究和一项定性研究符合纳入标准。该综述确定了多种障碍,如经济限制、结构障碍和心理因素,这些因素阻碍了社会边缘化青年获得牙科护理设施。三项研究在美国进行,两项在澳大利亚进行,一项在英国进行,一项在肯尼亚进行。在识别出的障碍中,四项研究分别报告了经济限制以及结构和后勤方面的挑战,而一项研究报告了牙科护理的心理障碍。在这一人群中观察到龋齿和牙周病等未满足需求的高患病率。纳入研究中识别出的未满足的牙科需求包括龋齿(=3)、缺牙(=2)、牙周病(=1)、牙痛(=1)和牙科感染(=1)。然而,样本量小且缺乏稳健的研究设计限制了研究结果的普遍性,强调需要对社会边缘化青年的口腔健康结果进行更多样化的研究。
本范围综述确定了社会边缘化青年在获得口腔健康和牙科服务利用方面的关键研究空白。有必要开展口腔健康倡议,以减少社会边缘化青年中的口腔健康不平等现象。