Scoping Review of Interventions Enhancing Accessibility to Preventive Dental Care for Racially Marginalized Populations

Background:
Oral health disparities have persisted as a significant public health issue in the United States, disproportionately impacting racially marginalized communities. These disparities manifest through limited access to preventive dental services and poorer oral health outcomes. Although community-based interventions have been developed to address these issues, a comprehensive understanding of their scope, strategies, and theoretical grounding is lacking. This scoping review aimed to explore existing interventions designed to improve access to preventive dental care for racially marginalized populations, identify the structural and individual barriers addressed, and examine the theoretical and practical implications of these efforts.

Methods:
A scoping review methodology was applied using Arksey and O’Malley’s (2005) framework and the PRISMA-ScR guidelines. A systematic search was conducted in Medline, CINAHL, and Web of Science databases for peer-reviewed studies published before June 12, 2024. Search terms included combinations related to oral health, accessibility, prevention, and racial or ethnic minority groups. Inclusion criteria consisted of studies describing interventions aimed at increasing access to preventive dental care for racially marginalized populations in the U.S. A total of 24 studies met the inclusion criteria and were reviewed for key themes, implementation strategies, theoretical underpinnings, and reported outcomes.

Results:
Most interventions focused on enhancing access through community-based models, interprofessional collaboration, and culturally tailored programming. Common strategies included partnerships between dental schools and community-based organizations, mobile dental units, school-based services, and the involvement of community health workers. These efforts addressed barriers such as transportation, cost, and lack of trust in dental providers. Programs often emphasized culturally responsive approaches that helped build community trust and increase service utilization. However, most studies lacked rigorous evaluation designs. Few employed randomized control trials, and many relied on small, non-random samples. Theoretical frameworks were often underutilized, and studies rarely considered intersectional factors such as race, class, and structural barriers. While increased utilization of services was a frequently reported outcome, few studies measured long-term impacts such as reduced disease prevalence or improved overall well-being.

Conclusions:
The findings highlight promising community-level strategies for addressing oral health disparities, yet underscore the need for more rigorous, equity-focused, and theoretically informed research. Structural factors such as systemic racism, socioeconomic inequality, and language barriers were consistently reported as critical challenges influencing access to care. The persistence of the “paradox of need”—where those with the greatest need had the least access—emphasized the importance of addressing structural determinants. Future interventions should incorporate structural competency, anti-racist practices, and community-based participatory methods. Long-term outcome evaluations are essential to support policy change and inform sustainable models of care. This review contributes to the field of social work by illustrating how practitioners can promote health equity through inclusive service delivery, advocacy, and interdisciplinary collaboration in both health and social service systems.