How dental shame undermines oral health and equity

Dental Tribune International

Tue. 21. October 2025

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COPENHAGEN, Denmark: A new interdisciplinary commentary by researchers in Denmark calls for dentistry to confront one of its most powerful but overlooked barriers to care: shame. Researchers argue that “dental shame”—the feeling of humiliation or self-consciousness linked to oral health—can shape behaviour, deepen inequalities and prevent people from seeking the very care they need to recover confidence and well-being.

The investigation of shame within the context of dental care is by no means a new thing. A study from 2004, for example, showed how feelings of social powerlessness and embarrassment were driving factors behind dental anxiety and resultant avoidance of care. Building on these foundational insights, the authors of the Danish article expand the focus to shame anxiety and give an overview of how shame operates across personal, social and systemic dimensions of oral health. In oral healthcare, it manifests when people feel judged for the condition or appearance of their teeth, their dental neglect or their lifestyle choices, such as smoking or diet. This emotion arises not only in dental settings but also in the course of everyday life, for example in social encounters and in interactions with wider health and social services.

The paper identifies dental shame as both a cause and a consequence of oral health problems. Embarrassment about dental neglect can lead to avoidance of care, which in turn worsens oral disease—creating a self-reinforcing spiral. The effects reach far beyond oral health, influencing employment prospects, self-esteem and even social participation.

Importantly, dental shame intersects with structural inequities. People experiencing poverty, trauma, homelessness or social marginalisation are disproportionately affected. The authors warn that fee structures, public messaging and even clinical interactions can unintentionally amplify shame and exclusion.

To address this, the paper calls for shame-sensitive practice across dentistry and other fields of healthcare. This includes cultivating the ability to recognise and respond empathetically to shame dynamics in clinicians, educators and policy designers. By understanding how shame operates, professionals can create more inclusive and non-judgemental environments that foster trust and engagement. The authors suggest that, ultimately, tackling dental shame offers a route to improved oral health outcomes, greater health equity and more compassionate dentistry—transforming not only smiles but lives.

The commentary, titled “Dental shame: A call for understanding and addressing the role of shame in oral health”, was published online on 21 September 2025 in Community Dentistry and Oral Epidemiology, ahead of inclusion in an issue.

Topics:

General Dentistry

Tags:

Access to care Dental anxiety Dental research Health inequality Oral health psychology Socioeconomic characteristics

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