Theoretical approaches in Dental Public Health: What does this mean?

Objectives: To identify different theoretical approaches in Dental Public Health based on the published literature.
Methods: Hermeneutic study that began with a search for secondary sources in electronic databases, combining the MeSH terms: social-determinants, socioeconomic-factors, dental public health, social class, oral-health, oral-condition. Only articles published in English, Portuguese or Spanish, available in full text from the National University of Colombia were included in the analysis. Four researchers read the articles separately and then, consensus meetings were held to identify the underlying theoretical approach of each paper.
Results: Forty-six articles met the inclusion criteria, 42 in English. Nineteen came from Brazil, 8 from the UK and 7 from the US. The main theoretical approach used was the social determinants of health (38 articles), followed by psychosocial theory (4), the theory of social/political production of disease (3) and eco-social theory (1). Among those with a social determinants of health perspective (29 empirical and 9 theoretical), 44.7% were from Brazil, followed by 18.4% from the UK. The most studied determinants were: education (8) income (7), race/ethnicity (5) gender (3), social class, occupation, economic status and social-networks (2 each).
Conclusions: The literature published on "dental public health" has increased in the last decade and is based on four theoretical approaches: Psychosocial theory: Suggests that different psychosocial stressors result in biological effects. Social production of disease/political economy of illness: Argues that the political and economic institutions are the basis of social inequalities in health. Eco-social theory: Levels interact in a hierarchical manner. Social determinants of health (WHO): Social factors determine biological conditions. We conclude that, in empirical studies, the determinants of education, income, race, gender, and social class/position were the strongest to understand the process of social stratification. Also, they reflect the unequal distribution of resources and power; thus generating social gradients in oral health.