Structural Ableism in Dentistry

Ableism is a system of beliefs, norms and practices that privileges non-disabled bodies and minds while devaluing and disadvantaging disabled people. Disabled people experience persistent oral health inequalities, yet dentistry has largely framed disability as an individual clinical challenge rather than a structural question. In this critical commentary, we apply a structural ableism framework to dentistry and examine how dental education, research, policy and service delivery reproduce normative assumptions about bodies, communication, behaviour and eligibility for care.

Drawing on a purposive, non-systematic body of scholarship from disability studies, public health and oral health, predominantly focusing on the UK context, we organise the discussion around six interconnected guiding principles: interrogating dentistry's role; resisting biomedical universalism; attending to cultural context; connecting ableism with other systems of oppression; examining upstream as well as proximate pathways; and dismantling institutional and epistemic ableism.

We argue that inaccessible facilities, inflexible systems, exclusion from research and the positioning of disability as peripheral or 'special' are not merely separate access problems. They become structural ableism when they arise from, and are repeatedly sustained by, institutional rules, resource decisions and professional norms organised around a non-disabled ideal.

We propose a framework for action spanning dental schools, services, policymakers, regulators, researchers, and journals. Progress requires structural as well as clinical change, developed with disabled people as partners and experts.