Collaborative Approaches to Addressing Oral Health Inequities: Social Work's Role and Impact in Dental Education

Background and Purpose: Oral health inequities are a marker of social injustices experienced throughout a person’s life. Poor oral health reflects a higher burden of disease, disparate access to health care, material hardship, and other physical and social inequities. While social workers continue to have established roles in hospitals and community health centers, oral health has been slow to adopt social workers into dental settings despite pervasive oral health inequities. Social workers are uniquely positioned to be effective members of oral healthcare teams, yet their roles in these settings remain underexplored. This study examines social work's role and perceived impact in dental schools.

Methods: A two-phase explanatory sequential mixed methods design was conducted with social workers in the national Social Work in Dentistry (SWID) group. The first phase collected quantitative data via survey methods (N=12). The survey included questions on demographics, their role and setting, social work field education, program funding, and facilitators in and barriers to establishing integrated social work oral health programs. The second phase collected qualitative data via semi-structured interviews (N=6). The interview guide included questions focused on 1) the history of how they came to their role, 2) exploring the role of the participant in their institution, 3) exploring how others in the dental school perceive their role in the dental school, 4) exploring their role in health equity, and 5) barriers and facilitators of their role in dental education. Mixed methods integration occurred in developing the semi-structured interview guide from the survey results and the analysis phase.

Results: Respondents described their role as multifaceted and included three main responsibilities: (1) direct clinical practice and care coordination (83%); (2) teaching dental school curriculum (75%); (3) supervising master’s level social work students (83%). The main barriers to social work integration included 1) social work isolation, 2) how to show value, and 3) unfamiliarity with social work’s scope of practice. The main facilitators of social work integration included 1) dental champions, 2) interprofessional collaboration, and 3) shared values. Respondents perceived promoting health equity through a trauma-informed, anti-oppressive lens as one of the most prominent aspects of their role. Through direct care that addresses a patient’s holistic needs, social workers were able to elevate population health needs and oral health equity.

Conclusions and Implications: Social workers in dental schools serve a dynamic role, including cross-system collaborations for improved patient and student outcomes. Social workers and their training are perfectly primed to collaborate with dentists to address social determinants of health in clinical practice and be leaders in addressing oral health inequities, especially among vulnerable populations. Integrating social workers in oral health education can help influence a new generation of dental providers who will go beyond their two-millimeter view to address patients’ psychosocial needs through holistic and patient-centered care.