Social determination of the oral health-disease process: a social-historical approach in four Latin American countries.

OBJECTIVE: This study sought to contrast the perspectives on the social determination of oral health present in the scientific literature published in Colombia, Brazil, Ecuador, and Mexico since 1970 until 2012. METHODOLOGY: This was a cross-sectional descriptive study on the Latin American scientific production published in specialized databases between 1970 and 2012. RESULTS: The social determination of oral health in Latin America is characterized by the conflict among the players when seeking to overcome the limitations and traditional perspectives in health. The differences among the countries studied are explained by the existing relationship among research, higher education, and the socio-political trajectories of the countries and the similarities by health systems that have permitted accumulation of inequities in health. In Brazil, the concern for the individual and collective in local settings is important, while in Ecuador, Mexico, and Colombia the explanation based on the social determinants of the diseases predominates. CONCLUSION: The view of the social determination of the oral health-disease process in Latin America is characterized by a continuous dispute between emancipation and accumulation approaches. The scant impact of social determination in oral health obeys to the history of the odontology profession, the predominance of care policies and services of technical care nature.