Generators of Inequality and Inequity Affecting Dental Patient Safety: A Grounded Theory Approach

This study aimed to understand, through the voices of patients, the factors that contribute to inequality and inequity in oral healthcare and their implications for patient safety. A qualitative study was performed using a Grounded Theory approach (GT) through 13 in-depth interviews with a flexible design, recorded and transcribed verbatim for study purposes. Open and axial coding and analysis categories were generated, and a conceptual and explicative framework was established. Ethical approval was obtained. The main findings highlighted how individual, social, and contextual factors significantly influence the materialization of risks and failures in oral healthcare, ultimately affecting patient safety in dental practice. These factors include individual factors, the relationship between professionals and patients, and failures in healthcare service provision. Participants' discourses showed examples of inequities, such as gender, socioeconomic gradient, educative level, type of healthcare system, discrimination, stigmatization, and othering-otherness, and their effect on dental care and dentistry safety. Health inequities should be tackled in a preventive and proactive manner through the effective integration of intersectoral policies and strategies. This approach would enhance oral health, make patient safety a fundamental pillar of dental care, uphold human dignity, and strengthen trust in the healthcare system.