Susan Fisher-Owens Conceptual Model of Social Determinants of Oral Health (2007)

Susan Fishser-Owens noted the substantial improvements in oral health brought about by fluoridation and improved dental hygiene, but dental caries remain prevalent. Her conceptual model was based on other social epidemiology approaches, and an understanding that "influences do not act in isolation but rather via complex interactions." Her model presents several layers of influences on a child'r oral health: "This model builds on the previous work cited above and, importantly, incorporates influences in each of the 5 major domains identified by past research. In addition, it presents a multilevel conception
of how these factors influence outcomes." "Sufficient concurrences exist between factors affecting health in general and oral health in particular, so including them in a conceptual model is reasonable, even if specific effects on oral health have not yet been identified. A time element is included, recognizing that children’s oral health is dynamic; each child has a unique developmental trajectory. Lastly, implicit in the model is the concept of vulnerability and resilience. Specifically, psychobiological and medical research shows that some people possess characteristics enabling successful adaptation to adversity. This can
happen on a biological (host resistance to microbiologic attack) or population (individual ability to overcome adverse housing, socioeconomic, or violent environments) level, which can protect against or predispose to poor outcomes."

Susan A. Fisher-Owens, SA Gansky, LJ Platt, et al. Influences on children's oral health: A conceptual model. Pediatrics 2007;120(3); e510

Model of the social influences on dental health