Bridging Gaps in Oral Health Frameworks: Mapping With Hodges' Health Career - Care Domains - Model

Area of Science:

• Public Health
• Health Policy
• Health Services Research

Background:

• Persistent inequities in oral health outcomes and access remain despite global strategies.
• Current oral health frameworks often fail to integrate clinical, behavioral, social, cultural, and political determinants.
• A comprehensive meta-framework is needed to evaluate existing models and identify conceptual gaps.

Purpose of the Study:

• To map and evaluate existing oral health conceptual frameworks using Hodges' Health Career-Care Domains-Model (HCM).
• To identify conceptual gaps and opportunities for greater integration within oral health frameworks.
• To assess the representation of clinical, behavioral, sociological, and political domains in current models.

Main Methods:

• A structured scoping review of oral health conceptual frameworks published between 1995 and 2025 was conducted.
• Databases searched included MEDLINE, CINAHL, EBSCO, and Google Scholar.
• Frameworks were categorized by theoretical orientation and mapped against the four HCM domains.

Main Results:

• Twenty-one frameworks met inclusion criteria and were classified into balanced, clinically led, or policy/public health-focused groups.
• Seven cross-cutting themes emerged, including health promotion, systems integration, social justice, and cultural safety.
• Many frameworks promoted equity but lacked implementation guidance or empirical validation; political and structural domains were consistently underrepresented.

Conclusions:

• The Health Career-Care Domains-Model (HCM) effectively highlighted the underrepresentation of political and structural domains in oral health frameworks.
• HCM provides a practical tool for developing integrated oral health models.
• The findings support the development of models aligned with equity, sustainability, and universal health coverage goals.