Upstream Interventions to Promote Oral Health and Reduce Oral Health Inequalities: A Scoping Review

Area of Science:

• Public Health
• Health Policy
• Oral Health Research

Background:

• Socioeconomic status significantly impacts oral health outcomes.
• A gap exists in understanding upstream interventions for oral health promotion and equity.
• Global evidence on upstream strategies for oral health is limited.

Purpose of the Study:

• To map global evidence on upstream interventions promoting oral health.
• To identify upstream interventions reducing socioeconomic inequalities in oral health.

Main Methods:

• Scoping review conducted following Joanna Briggs Institute (JBI) methodology.
• Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist.
• Comprehensive search strategy and rigorous article selection process.

Main Results:

• 99 articles included: 74 empirical studies, 25 reviews.
• Limited upstream interventions identified specifically for oral health promotion and inequality reduction.
• Effective interventions include legislative/regulatory measures, fiscal policies (e.g., SSB taxes), and water fluoridation.

Conclusions:

• A scarcity of upstream interventions targeting oral health and its inequalities was found.
• Identified interventions operate at three levels: socio-political determinants, non-communicable disease links, and specific oral health actions.
• The upstream approach is crucial for future public health policy in promoting oral health and equity.