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Objectives: To conduct a scoping review of existing research on the social determinants of health, sugar consumption and public health policy responses to address or improve health outcomes. Methods: A total of 13 categories were developed to reflect the authors' interest in the overall focus on the social determinants of health, sugar as an independent risk factor, upstream policy action ('whole populations'), downstream policy action ('targeted') and two contemporary policy strategies (namely 'Vulnerable populations' and 'Proportionate Universalism'). The search strategy was then performed on MEDLINE (via Ovid) and Web of Science, and was limited to the English language. No time limits prior to when the database search was conducted in 2022 were set to explore the full extent of the literature in this field. Results: Five hundred and sixty articles were retrieved, of which 181 met the criteria for review. When all categories were applied, the findings showed that 76% of papers focusing on sugar consumption as a risk factor for non‐communicable diseases (NCDs) mentioned the social determinants of health. The majority of studies (60%) recommended downstream interventions, with 40% recommending 'upstream' interventions. A limited proportion (12%) of research work was published in dental journals. Research had been done using predominantly quantitative methods (66% of articles), with 24% of studies adopting a mixed methods approach, and 8% being exclusively qualitative. Research on contemporary strategies for sugar reduction were focused on the 'Global North' and 98% of papers used individual level data focused on targeted approaches, highlighting that there is little direct evidence for contemporary strategies aimed at reducing sugar consumption. Conclusions: Whilst the majority of public and dental health research argues that there is a need to address the social determinants of health, the findings from this study highlight that very few empirical studies have been designed to directly inform contemporary strategies for sugar reduction. More research is therefore needed that can directly assess the evidence for contemporary strategies in public health policy. [ABSTRACT FROM AUTHOR]

Major sociohistorical processes have profound effects on oral health, with impacts experienced through structural oppression manifested in policies and practices across the lifespan. Structural oppression drives oral health inequities and impacts population‐level oral health. In this global perspective paper, we challenge old assumptions about oral health inequities, address misleading conceptualizations in their description and operation and reframe oral health through the lens of intersecting systems of oppression. Furthermore, we emphasize the need for oral health researchers to explore causal pathways through which oppression harms oral health and engage in social science concepts to understand the root causes of oral health inequities fully. Finally, we call on policymakers, dental scholars and decision makers to consider health equity in all policies and to take a systems‐oriented approach to effectively address oral health inequities. [ABSTRACT FROM AUTHOR]

At times of major geopolitical conflict, macroeconomic crisis and the 'aftershocks' of the COVID‐19 syndemic still having a global impact, it is the most vulnerable and disadvantaged in society who undoubtedly suffer the most. During these turbulent and uncertain times, it is essential that sufficient policy attention is given to tackling the persistent and stark health inequalities that exist both between and within countries. This commentary aims to critically reflect on developments in oral health inequalities research, policy and practice over the last 50 years. Despite often challenging political contexts, progress has undoubtedly been made in our understanding of the nature and underlying social, economic and political causes of oral health inequalities. A developing body of global research has highlighted patterns of inequalities in oral health that exist across the lifecourse, but less progress has been made in implementing and evaluating policy interventions to tackle these unfair and unjust inequalities in oral health. At a global level through WHO leadership, oral health is at a 'tipping point' with a unique window of opportunity for policy change and development. Transformative policy and system reforms co‐produced with community and other key stakeholders are now urgently needed to tackle oral health inequalities. [ABSTRACT FROM AUTHOR]

In the following discussion, we present a quick conceptual history of healthy equity and health justice, some plausible outcomes from the Covid‐19 pandemic for the public's understanding of these concepts, and some recent and relevant learnings for realizing equity and justice that could be useful for dental public health and beyond. [ABSTRACT FROM AUTHOR]

Oral conditions are highly prevalent globally and have profound consequence on individuals and communities. Clinical (e.g. dental treatments, behavioural counselling) and non‐clinical (e.g. community‐based programming, water fluoridation, oral health policy) evidence‐based interventions have been identified, recommended and applied at the clinic, community and policy levels. Still, the burden of oral conditions persists, with inequitable distribution across populations. A major driver of this lack of progress is poor translation of research findings, which results in an evidence‐to‐practice gap. Dissemination and implementation science (DIS) has emerged to address this gap. A relatively new field, application of DIS represents an important avenue for achieving good dental, oral and craniofacial health for all. The goal of this introductory article is to provide a brief background on DIS relevant to researchers in dentistry and oral health. The problem of knowledge translation, basic concepts and terminology in DIS, and approaches to doing dissemination and implementation research—including implementation strategies, key outcomes, and implementation theories, models and frameworks—are discussed. Additionally, the article reviews literature applying DIS to dentistry and oral health. Results of published studies and their implications for the field are presented. Drawing on the literature review and contemporary thinking in DIS, current gaps, opportunities and future directions are discussed. Resources for understanding and applying DIS are provided throughout. This article serves as a primer on DIS for dental and oral health researchers of all types working across a range of contexts; it also serves as a call to action for increased application of DIS to address the burden of oral conditions globally. [ABSTRACT FROM AUTHOR]

Objectives: To assess the association between sugar from sugar‐sweetened beverages (SSBs) and untreated decay in permanent teeth and calculate the cost burden of sugar from SSBs on untreated decay in US adults. Methods: Cross‐sectional data from the 2013–2014 and 2015–2016 cycles of the National Health and Nutrition Examination Survey (NHANES) were analysed in 2020 (n = 9001 adults aged ≥20). Multivariable analyses assessed sugar intake from SSB consumption with the presence of untreated decay in permanent teeth and number of untreated decayed teeth. Population attributable risk was used to estimate the cost burden arising from SSBs on untreated decay in US adults. Results: One fourth (25.1%) of US adults had untreated dental decay, and higher prevalence was observed among those with low income, low education and race/ethnicity of non‐Hispanic Black. Overall, 53% of adults reported no intake of SSBs. For the remaining 47%, the median 24‐h intake was 46.8 g of sugar from SSBs. The adjusted prevalence ratio (PR) for untreated decay was 1.3 (95% confidence interval [CI] 1.1–1.5) for consumption of 46.8 g or more of sugar from SSBs compared to those reporting no sugar from SSBs. Number of untreated decayed teeth increased with sugar intake from SSBs from lowest to highest tertile: 0.1, (p =.35); 0.4, (p =.006); and 0.6, (p <.001). The cost burden of untreated decay attributable to SSBs in US adults is estimated conservatively at $1.6 billion USD. Conclusions: Community level interventions directed at sugar from SSBs are justified to address disparities in the burden of untreated dental decay. [ABSTRACT FROM AUTHOR]

Objectives: We examined the effect of fluoridation cessation on children's dental caries experience in the Canadian cities of Calgary (cessation in 2011) and Edmonton (still fluoridated). Methods: We used a pre‐post cross‐sectional design with comparison group. We studied Grade 2 schoolchildren (approximately 7 years old) 7‐8 years after fluoridation cessation in Calgary, thus capturing children born after cessation occurred. Data collection included a dental examination conducted in school by calibrated dental hygienists, a questionnaire completed by parents, and fingernail clippings for a small subsample. Our overall analytic approach was twofold. We first examined differences in dental caries experience (deft and DMFT, and smooth surface caries based on defs and DMFS) between Calgary and Edmonton and over time (comparing 2018/2019 data to pre‐cessation and early post‐cessation surveys in our setting). Second, we evaluated whether differences were likely to reflect fluoridation cessation in Calgary, rather than other factors. Results: The prevalence of caries in the primary dentition was significantly higher (P <.05) in Calgary (fluoridation cessation) than in Edmonton (still fluoridated). For example, crude deft prevalence in 2018/2019 was 64.8% (95% CI 62.3‐67.3), n = 2649 in Calgary and 55.1% (95% CI 52.3‐57.8), n = 2600 in Edmonton. These differences were consistent and robust: they persisted with adjustment for potential confounders and in the subset of respondents who were lifelong residents and reported usually drinking tap water; they had widened over time since cessation; and they were corroborated by assessments of dental fluorosis and estimates of total fluoride intake from fingernail clippings. Findings for permanent teeth were less consistent, which likely reflects that 7‐year‐olds have not had the time to accumulate enough permanent dentition caries experience for differences to have become apparent. Conclusions: Our findings are consistent with an adverse impact of fluoridation cessation on children's dental health in Calgary and point to the need for universal, publicly funded prevention activities—including but not limited to fluoridation. [ABSTRACT FROM AUTHOR]