A Smile is Worth a Thousand Words: Individual Versus Structural Explanations of Poor Oral Health

Individuals with poor oral health encounter difficulties often attributed to personal failings. The current mixed-methods study extends stratification beliefs research into the scholarship of oral health inequality; this research explores undergraduate students' conceptualization of “oral health” by examining differences in their perspectives regarding individualistic and structuralist explanations of inequities in oral health based on race, gender, and political ideology. The participants attended a large, predominantly white, public, regional university in the Southeast region of the United States. In the study's first phase, 136 participants completed a qualitative survey to conceptualize the difference between “good teeth” and “bad teeth.” Findings from the first phase informed the development of a quantitative survey administered to 534 different participants in the study's second phase. Descriptive and multivariate analyses were used to investigate the association of race, gender, and political ideology based on “individualistic” and “structuralist” explanations of oral health inequality. Respondents favored individualistic over structuralist reasons for poor oral health outcomes. White respondents showed less support for both individualistic and structuralist explanations. Women emphasized structuralist explanations of poor oral health more than individualistic ones. Politically conservative respondents assigned more importance to individualistic explanations compared to structuralist explanations. Assessing oral health stratification beliefs can help scholars, practitioners, and lawmakers develop policies that make oral health included in overall health and welfare.