SARS-CoV-2 pandemic reshaped oral care inequities in Sweden

Dental Tribune International

Mon. 2. February 2026

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UMEÅ, Sweden: As post-pandemic research continues to examine how different public health responses shaped oral healthcare access and outcomes, a new study has turned its focus to Sweden, where authorities relied largely on individual responsibility rather than strict lockdowns. The researchers identified notable and sometimes unexpected shifts in unmet oral care needs among Swedish adults during the pandemic.

The study, conducted by researchers from Umeå University, the University of Eastern Finland and Simon Fraser University in Canada, analysed data from a nationally representative survey of 31,493 adults collected in 2018 and 2021. By applying analytical methods that considered socio-demographic characteristics both individually and together, the team examined how perceived inequities in unmet oral care needs evolved across different socio-demographic groups before and during the pandemic.

Overall, the prevalence of unmet oral care needs increased among adults in Sweden during the pandemic. However, the findings also revealed complex and uneven changes across population groups.

Older adults experienced a notable rise in unmet needs, underscoring their vulnerability during the pandemic period. By contrast, immigrants showed a decrease in inequities. On average, individuals with low levels of education and income experienced modest increases in unmet dental care needs.

When multiple dimensions of disadvantage and advantage were considered simultaneously, the multiple-characteristic analysis revealed further nuances. Socially privileged older adults—those with higher income and education—experienced increased unmet care needs. Conversely, immigrants and younger adults facing multiple social disadvantages showed improvements in relative equity during the pandemic.

Overall, the largest reductions in oral care inequities occurred in population groups that had experienced the greatest inequities prior to the pandemic.

Reductions in inequities were mainly observed among men under 65 years of age, particularly immigrant men aged 45–64 years with high income and low education, as well as Sweden-born men aged 24–44 years with low income and high education. Decreases were also seen among immigrant men and women with low education, both among those aged 45–64 years with low income and those aged 65–84 years with high income. Overall, the largest reductions in oral care inequities occurred in population groups that had experienced the greatest inequities prior to the pandemic.

The authors suggest that Sweden’s pandemic strategy may have influenced how people engaged with health-seeking behaviours, including oral care. They note that the pandemic appeared to reconfigure existing inequities: some groups defined by combinations of socio-demographic characteristics experienced increased unmet needs, and others saw improvements. These shifts may reflect differences in care-seeking behaviour shaped by the emphasis on individual responsibility, as well as by gaps in public health communication reaching all segments of the population.

The findings highlight the importance of targeted and equitable strategies during future public health emergencies to ensure continued access to oral care services. Tailored interventions focusing on older adults and other medically vulnerable groups are particularly critical, alongside sustained efforts to address barriers faced by socially marginalised populations, including immigrants.

In addition, because the multiple-characteristic model demonstrated slightly better predictive accuracy than the single-characteristic approach did, the study underscores the value of looking beyond individual socio-demographic factors to better understand oral health inequities and more accurately predict unmet care needs.

The study, titled “Impact of the COVID-19 pandemic on intersectional inequities in unmet oral care needs in Sweden”, was published online on 21 January 2026 in JDR Clinical and Translational Research, ahead of inclusion in an issue.

Topics:

General Dentistry

Tags:

COVID 19 Dental inequalities Dental research Oral health psychology SARS-CoV-2 pandemic Sweden

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