A new international study suggests that Sweden’s light-touch pandemic response reshaped access to oral care, leading to an overall rise in unmet dental needs but uneven effects across different population groups.
Researchers from Ume? University, the University of Eastern Finland and Simon Fraser University in Canada analysed data from a nationally representative survey of 31,493 Swedish adults collected in 2018 and 2021. The team compared oral care access before and during the COVID-19 pandemic, focusing on perceived unmet dental care needs.
The study found that unmet oral care needs increased among Swedish adults during the pandemic. However, the changes varied significantly by age, income, education and migration background.
Older adults experienced a clear rise in unmet dental needs, highlighting their increased vulnerability during the pandemic. People with lower income and education levels also saw modest increases. In contrast, immigrants showed a reduction in oral care inequities overall.
When researchers examined multiple socio-demographic factors at the same time, more complex patterns emerged. Socially advantaged older adults—those with higher income and education—reported increased unmet needs. Meanwhile, younger adults and immigrants facing multiple disadvantages experienced improved equity in access to oral care.
The largest reductions in inequities were observed among groups that had faced the greatest barriers before the pandemic. These included men under 65, particularly immigrant men aged 45–64 with high income but low education, and Sweden-born men aged 24–44 with low income and high education. Decreases were also seen among immigrant men and women with low education in both middle-aged and older groups.
The authors suggest that Sweden’s reliance on individual responsibility during the pandemic may have influenced health-seeking behaviour, including decisions about dental care. Differences in risk perception and gaps in public health communication may have contributed to the shifting patterns of access.
The researchers emphasise the need for targeted and equitable strategies in future public health emergencies to protect access to oral care. They stress the importance of focused support for older adults and medically vulnerable groups, while continuing efforts to reduce barriers for socially marginalised populations, including immigrants.
The study also found that analysing multiple socio-demographic characteristics together provided slightly better predictions of unmet oral care needs than examining single factors alone. This approach, the authors say, can offer a clearer picture of oral health inequities and help guide more effective policy responses.