Oral Health And Stigma Flashcards
What aspects affect a patient’s experience of health?
- Biological factors: physical, biochemical, biomedical, doctors/dentists, disease
- Social factors: reflecting on social/cultural meanings associated with the illness, the meanings people attribute to their illness to help them make sense of their illness experiences
Why should dentists be interested?
- How patients perceive their oral health and any related symptoms is very important to their care.
- Patient perceptions of oral health can influence their compliance with oral health advice and treatment.
- Patient’s readiness to change is influenced by social factors.
What social meanings could poor oral health be associated with?
- Social vulnerability
- Poverty
- ‘Different’ from the rest of society
What is stigma?
Stigma is a social process experienced or anticipated, characterised by exclusion, rejection, blame or devaluation that results from experience, perception or reasonable anticipation of an adverse social judgement about a person or group.
Leads to feelings of shame and blame.
Why do dentists need to know about stigma?
Because it may prevent people getting help, delay treatment and impair recovery.
It makes people feel isolated and excluded from day to day activities and may stop people getting jobs.
What are the different types of stigma?
- Stigma of the body - evident/known about and identity is discredited or spoiled (therefore the stigma is managed or concealed)
- Stigma of social groups- evident/known about and identity is discredited or spoiled (therefore managed or concealed)
- Stigma of character- not immediately evident so your identity is discernible (therefore person can decide whether to disclose or conceal the stigma)
How does stigma work?
- People/society identify difference and label it as different (stigma)
- These labels are linked with a negative stereotype (prejudice)
- Negative stereotypes/labels place the labelled person in a category that isolates them from others/majority
- Creates ‘us’ and ‘them’ (minority vs majority)
- The ‘us’ and ‘them’ divide separates people in terms of resources and power (discrimination)
What is ‘self-stigma’?
When individual’s internalise/accept the negative stereotypes.
Poor dental health can lead to self-stigma.
Can an illness be stigmatising?
There is nothing about the illness that is stigmatising, it is society’s response to the condition that makes it stigmatising.
What are the four domains of stigma?
- Fear
- Values
- Discrimination
- Disclosure
How do we know if a patient feels stigmatised about their dental health?
- Fear: does the patient avoid social encounters
- Values: does patient feel a sense of shame or embarrassment about their appearance?
- Discrimination: do society/people treat them differently because of their dental appearance/health?
- Disclosure: are they afraid to disclose the actual state of their teeth? Are they reluctant to seek professional help?
Is having poor oral health stigmatising?
Bad, discoloured teeth and crooked teeth are interpreted as a sign of self-neglect and poverty and a cause of shame for the person. Lots of people find ways to conceal their bad teeth…
Are missing teeth a sign of social marginalisation?
They’re a tell take sign of having been incarcerated and this stigma stays with prisoner after release according to Williams 2007.
International research supports this claim with the finding that prison dentists are more likely to extract rather than restore teeth.
Missing teeth as a sign of deprivation?
Cost prevents people from getting dental care?
Horton and baker research with migrant workers and their families shows that poor dental health impacts on their sense of self.
Missing teeth as a sign of violence/trauma?
Double stigma: being the victim of intimate partner violence and missing teeth.
‘Its hard to move forward when you’re constantly reminded with missing teeth that you were a victim’. Survivor of intimate partner violence.
