Blog by Patricia Neville
As a social scientist working in oral health research and dental education, I am regularly frustrated about how closed dentistry is to the behavioural and social sciences. Working as a sociologist in oral health research can be a lonely place. I am treated as an “exotic animal” with “curious” tools and “magical” epistemology. As a dental educator of sociology of health, I must contend with a hidden curriculum that teaches students to value the biomedical approach and its reductive clinical gaze over sociological insights (Neville et al. 2019). Historically, behavioral and social science research in oral health has been conceptualized as a “hand-maiden” to dentistry or as a “subordinate service-mode” project. While such outsider feelings are common for behavioural and social scientists working in medical/clinical fields (Albert, Paradis, and Kuper 2015), the ghettoization of the social and behavioural sciences within dentistry is not simply an academic concern. Efforts to improve the oral health of the global population will continue to lag further behind if clinical dentistry does not address this epistemic shortcoming.
A glimmer of hope recently emerged that may help turn around the fortunes of the behavioural and social scientists working in oral health and dental education. On 19 January 2022, the “Consensus Statement on Future Directions for the Behavioral and Social Sciences in Oral Health” was published in the Journal of Dental Research (McNeil et al. 2022). This statement was the outcome of a three-day Behavioral and Social Science Oral Health Summit held in 2020. This virtual global conference was the first of its kind to bring together over 400 oral health researchers, stakeholders and behavioural and social scientists working in oral health to discuss the role and place of behavioural and social sciences in oral health (International Association of Dental Research 2022). The resultant consensus statement highlights four key ways in which the behavioral and social sciences contribute to oral health research epistemology. These are:
- Behavioural and social theories and mechanisms related to oral health
- Use of multiple and novel methodologies in social and behavioral research and practice related to oral health
- Development and testing of behavioral and social interventions to promote oral health
- Dissemination and implementation research for oral health
While consensus statements are not new to healthcare (Blazeby et al. 2021), this consensus statement breaks new ground for several reasons:
- It provides a useful appraisal of the historic and ongoing work that behavioural and social scientists have undertaken on oral health, highlighting theoretical, methodological and empirical contributions.
- It serves to reframe behavioral and social science research in dentistry, presenting such research as a vehicle for knowledge synthesis and expanded expertise in its own right.
- It disrupts the epistemological echo chamber within the dental health community, since publication in a noted clinical journal represents a significant incursion – by behavioral and social scientists—into the biomedical world of dentistry.
The message is clear: the behavioural and social sciences have a productive and transformative impact on oral research and healthcare. How the dental community responds to this call for recognition and collaboration remains to be seen.
Albert, Mathieu, Elise Paradis, and Ayelet Kuper. 2015. “Interdisciplinary Promises Versus Practice in Medicine: The Decoupled Experiences of Social Sciences and Humanities Scholars.” Social Science & Medicine 126 (February): 17-25. https://doi.org/10.1016/j.socscimed.2014.12.004.
Barry, Andrew, and Georgina Born. 2013. Interdisciplinarity: Reconfigurations of the Social and Natural Sciences. London: Routledge.
Blazey, Paul, Kay M. Crossley, Clare L. Ardern, Marienke van Middlekoop, Alex Scott, and Karim M. Khan. 2021. “It Is Time for Consensus on ‘Consensus Statements.’” British Journal of Sports Medicine 56 (6): 306-307. http://dx.doi.org/10.1136/bjsports-2021-104578.
International Association of Dental Research. Press release. 2022. Future Directions for the Behavioral and Social Sciences in Oral Heath. Accessed May 31, 2022. https://www.iadr.org/about/news-reports/press-releases/future-directions-behavioral-and-social-sciences-oral-heath-0.
Kleinburger, Jessica, and Sara M. Strickhouser. 2014. “Missing Teeth: Reviewing the Sociology of Oral Health and Healthcare.” Sociology Compass 8, no. 11 (November): 1296-1314. https://doi.org/10.1111/soc4.12209.
McGrath, Chris. 2019. “Behavioral Sciences in the Promotion of Oral Health.” Journal of Dental Research 98 (13): 1418-1424. https://doi.org/10.1177/0022034519873842.
McNeil, Dan W., Cameron L. Randall, Sarah Baker, Belinda Borelli, Jacqueline M. Burgette, Barry J. Gibson, Lisa J. Heaton, George Kitsaras, Chris McGrath, and John T. Newton. 2022. “Consensus Statement on Future Directions for the Behavioral and Social Sciences in Oral Health.” Journal of Dental Research 101, no. 6 (June): 619-622. https://doi.org/10.1177%2F00220345211068033.
Neville, Patricia, Jez Zahra, Katie Pilch, Dasna Jayawardena, and Andrea Waylen. 2019. “The Behavioural and Social Sciences as Hidden Curriculum in UK Dental Education: A Qualitative Study.” European Journal of Dental Education 23, no. 4 (August): 461-470. https://doi.org/10.1111/eje.12454.
Patricia Neville is a sociologist and Senior Lecturer at Bristol Dental School. Her research interests are the sociology of oral health, healthcare professionalism and gender and equality issues in dentistry. Institutional Address: Bristol Dental School, University of Bristol, Lower Maudlin Street, BS1 2LY, UK.