Defining Disability in Oral Health Policy and Practice in the UK.

OBJECTIVES: In the United Kingdom (UK), disabled people face barriers accessing dental care, leading to poor oral health. To understand these barriers, the present study examined how disability is defined and conceptualised in UK oral health policy documents, and explored the implications of these framings for the provision of dental care for disabled people. METHODS: A qualitative documentary analysis was conducted using a seven-phase framework. Oral health policy documents published between 2000 and 2023 were identified through targeted website searches, supplementary web searches and consultation with an expert panel. Twenty-six national and international documents were included. Data were extracted using a structured matrix and analysed using a directed approach informed by the social model of disability. Coding was organised into three themes: disability terminology, underlying models of disability and vision for oral healthcare. RESULTS: Of the 26 documents analysed, 15 provided explicit definitions of disability, predominantly within Special Care Dentistry (SCD) guidance, while general oral health documents rarely defined the term. Most general dental policies adopted a medical model, focusing on individual impairments, whereas SCD and international documents were more likely to incorporate social or biopsychosocial approaches. Consideration of barriers to care, infrastructure requirements and workforce competencies was inconsistent and largely absent from general dentistry documents. A clear, system-wide vision for the provision of inclusive oral healthcare for disabled people was evident in only a small number of documents. CONCLUSIONS: UK oral health policy documents demonstrate inconsistent and often limited conceptualisations of disability, with a predominance of medical model approaches in general dentistry. The lack of clear definitions and absence of barrier-focused frameworks may contribute to ongoing inequalities in access to and outcomes of dental care for disabled people. Greater explicitness in defining disability, alongside the adoption of inclusive, barrier-oriented policy frameworks and increased attention to workforce development and service design, is required to support equitable and accessible oral healthcare.