Embracing Structural Competency in Current Dental Research for Future Equitable Oral Healthcare Delivery in India

India’s diverse population presents unique challenges in oral healthcare, demanding a shift towards structural competency.[1] While cultural competency has been the traditional approach to address healthcare disparities, it often falls short of addressing the systemic barriers that perpetuate inequities.[2] In the Indian context, where socio-economic disparities, inequalities, and geographic barriers significantly impact access to care, structural competency offers a more comprehensive framework.[3] Drawing from Alarcon et al.,’s insights, structural competency goes beyond individual biases and cultural understanding. It emphasises the need for oral healthcare providers to recognise and address the “web of interpersonal networks, environmental factors, and political and socio-economic forces” that shape a patient’s oral health. This requires understanding how social determinants of health, such as poverty, education, and access to resources, influence oral health outcomes.[4] In Indian society, its complex healthcare delivery system has an inherent structural vulnerability.[5] Resultantly, much deserving individuals may experience compromised oral health due to systemic inequities. Oral healthcare professionals must develop the ability to discern how symptoms and diseases are downstream implications of upstream decisions related to healthcare and food delivery systems, infrastructure, and even the very definitions of oral health.[6] Integrating structural competency into dental education is crucial. Curricula should move beyond basic medical sciences to address issues of race, class, gender, and other variables, enabling dentists to identify how political, economic, and institutional forces directly harm patients. This involves recognising biases towards diverse patient groups and understanding structural barriers related to transportation, appointment times, language, culture, and finances.[4] By embracing structural competency, Indian oral healthcare providers can move towards a more equitable and just system, addressing the root causes of oral health disparities and ensuring that all individuals have access to the oral care they need to thrive. As a start, more India-specific oral and dental research is this direction would be welcome.