Misalignment between Oral Health Values and Prioritization of Care Among Latino/a/e Adults

Introduction: It is well-documented that the Latino/a/e community experiences disproportionately high rates of oral health disease and some of the lowest rates of dental care utilization in the United States. While understanding the prevalence and patterns of oral health disparities remains critical, few studies examine how culture and broader sociopolitical conditions influence Latino/a/e adults’ values related to oral health, their perceptions of care-seeking, and the sources they trust for oral health information. This study aims to address this gap by exploring how Latino/a/e adults conceptualize, value, and prioritize their oral health, and how these understandings shape their engagement with care and overall oral health outcomes.

Methods: A convergent mixed methods study was conducted with a subsample of Latino/a/e adults (N = 20) drawn from the larger Philadelphia-based longitudinal study, the Philadelphia Economic Equity Project (PEEP). The study included two phases. In Phase One, participants completed a survey assessing oral health values and cultural identity. Oral health values were measured using the 12-item Oral Health Values Scale (OHVS). In Phase Two, semi-structured interviews were conducted to further explore participants’ oral health beliefs, daily practices, and experiences with care. Descriptive statistics were calculated for quantitative variables, and reflexive thematic analysis was used to analyze the qualitative data.

Results: Participants ranged in age from 25 to 62 years (M = 41.75, SD = 11.31), with 70% identifying as women and 55% identifying as Puerto Rican. The sample reflected immigrant generation diversity with 40% identifying as first-generation, 45% as second-generation, and 15% as third-generation immigrants. Educational attainment varied, with 50% holding a college degree or higher, 40% having a high school diploma, and 10% reporting less than a high school education. The average total OHVS score was 47.95 (SD = 7.34), with subscale means as follows: Professional Dental Care (M = 11.75), Appearance and Health (M = 13.50), Flossing (M = 10.25), and Retaining Natural Teeth (M = 12.45). Participants consistently emphasized the value of oral health as part of their systemic health, personal appearance, and social connection. However, 40% reported experiencing significant oral health problems, including tooth loss. While participants understood the importance of oral health, barriers such as financial resource strain, dental anxiety and fear, lack of early education, substance use, and other lifestyle factors often made it difficult to prioritize care.

Discussion & Implications: These findings highlight a misalignment between the value Latino/a/e adults place on oral health and their ability to prioritize and access care consistently. For social work practice considerations, this underscores the need to more explicitly incorporate oral health into biopsychosocial assessments, patient education, and interdisciplinary collaboration. At the policy level, this study points to the need for expanded Medicaid dental benefits, public health initiatives that increase oral health literacy, and integrated care models that embed social workers in oral health settings. Bridging the gap between values and access requires systems-level change, and social work can play a critical role in advancing oral health equity.