Shame is an emotion often relegated to the psychological realm, yet emerging research reveals its profound impact on physical health, particularly within the domain of oral care. A recent study highlights how dental shame, an underestimated yet potent force, deters individuals from seeking timely treatment for dental issues, thereby perpetuating and exacerbating oral health inequalities across diverse populations. This research underscores the imperative to deepen our understanding of dental shame to promote more effective and compassionate healthcare engagement.
Dental shame manifests both as an internalized stigma and a social phenomenon, often arising from an individual’s perception of their dental health or the aesthetic presentation of their teeth. These feelings can be especially acute among vulnerable groups, including those experiencing socio-economic deprivation, past trauma, or abuse. Furthermore, behaviors closely associated with oral health, such as smoking, drinking, and dietary habits, can intensify the shame response, creating a complex psychosocial barrier to accessing oral healthcare services.
The interplay between shame and health-seeking behavior is particularly insidious. When patients perceive judgment or discomfort during dental consultations, or when systemic healthcare structures inadvertently reinforce feelings of inadequacy, shame acts as a self-perpetuating cycle. This cycle leads to avoidance of dental care, resulting in worsening oral health conditions, which in turn intensify feelings of shame. The consequential spiral not only damages oral health but jeopardizes broader aspects of an individual’s wellbeing, including social integration and psychological resilience.
This research, conducted by a multinational team of scholars from prestigious institutions including the University of Copenhagen, the University of Exeter, and the University of Plymouth, brings to light the staggering underexplored dimension of shame in oral health. The interdisciplinary collaboration draws upon sociological, psychological, and clinical expertise, offering a robust framework for understanding how shame operates both on individual and systemic levels within oral healthcare settings.
One of the key findings emphasizes the dual nature of dental shame—it is simultaneously a consequence of existing oral health problems and a determinant that influences future health behaviors. Oral conditions such as tooth decay, gum disease, and aesthetic concerns are tangible triggers for shame, yet the resulting emotional distress may inhibit patients from adopting preventive measures or seeking restorative treatments. This bidirectional dynamic underscores the complexity of interventions needed to address the problem.
The visibility of teeth in human social interactions compounds the problem. Teeth significantly contribute to facial aesthetics and by extension, to self-esteem and social perception. Poor dental health and associated shame can therefore lead to social withdrawal, reduced employment opportunities, and diminished access to essential social services. The broader socio-economic repercussions of untreated dental issues illuminate why shame-based exclusion in healthcare has ramifications extending far beyond mere oral discomfort.
Healthcare practitioners hold a pivotal role in either mitigating or exacerbating dental shame. The study cautions against the intentional use of shame as a motivational tool, as this approach risks perpetuating stigma without guaranteeing positive health outcomes. Instead, the authors advocate for ‘shame competence’ training among dental professionals, equipping them to recognize subtle cues of shame, manage shame dynamics effectively, and foster empathetic, inclusive clinical environments that empower patients rather than alienate them.
Systemic inequities compound dental shame, particularly through healthcare policies and fee structures that disproportionately burden marginalized populations. Financial barriers and inflexible healthcare models can reinforce feelings of exclusion and unworthiness, further entrenching health disparities. The study draws attention to the necessity of reforming policy frameworks to reduce institutionalized shaming and promote equitable access to oral healthcare services.
In elderly care settings, dental shame assumes an even more critical dimension. The researchers involved in the Lifelong Oral Health project at the University of Copenhagen identified dental shame as a significant obstacle in improving oral health among the elderly. Older adults, often dealing with multiple vulnerabilities—physical, cognitive, and social—face unique challenges that necessitate tailored shame-sensitive approaches within dental and caregiving contexts.
Energy devoted toward fostering non-judgmental environments appears paramount. When patients feel trustful and respected, they are more likely to disclose sensitive information such as smoking habits or poor dietary patterns, which are vital for tailoring effective oral health interventions. Building these therapeutic alliances is fundamental in breaking the shame cycle and promoting health equity.
The article further elucidates the societal dimensions of dental shame, connecting it to broader social inequalities related to class, education, and healthcare access. Acknowledging these social determinants is essential for comprehensive public health strategies aimed at reducing oral health disparities and enhancing community well-being.
Finally, this insightful examination into the nexus of shame and oral health calls for a paradigm shift in both research and practice. Integrating shame competence into professional training, restructuring health policies to dismantle systemic barriers, and adopting patient-centered, compassionate care models represent crucial strides toward mitigating the pervasive impact of dental shame.
As dental care professionals and policymakers grapple with these revelations, the hope is that acknowledging and addressing dental shame will not only improve individual outcomes but also galvanize societal commitment to health equity and human dignity.
Subject of Research: People
Article Title: Dental Shame: A Call for Understanding and Addressing the Role of Shame in Oral Health
News Publication Date: 21-Sep-2025
Web References: http://dx.doi.org/10.1111/cdoe.70019
References: Folker L, Øzhayat EB, Jespersen AP, Dolezal L, Withers L, Paisi M, Worle C. Dental Shame: A Call for Understanding and Addressing the Role of Shame in Oral Health. Community Dentistry And Oral Epidemiology. 2025.
Keywords: Health equity, Health disparity, Health care policy, Health care delivery, Doctor patient relationship, Human health, Public health, Social class, Social conditions, Social inequality, Social problems, Social welfare
