La vergüenza por la pérdida de dientes: entre el sufrimiento psíquico y la desigualdad estructural en la salud oral chilena

Manuel Alejandro Castro Gatica; Karen Danke Hausdorf; Ingeborg Bevensee Canavati; Ana Beatriz Silva Lopes; Jorge Gamonal

doi:10.18294/sc.2026.5911

Shame over tooth loss: between psychological suffering and structural inequality in Chilean oral health

Manuel Alejandro Castro Gatica PhD in Sociology. Researcher and Assistant Professor, Faculty of Social Sciences, Department of Social Work, Universidad Alberto Hurtado, Santiago, Chile. , Karen Danke Hausdorf PhD in Dental Sciences. Research Professor, School of Dentistry, Universidad San Sebastián, Santiago, Chile. , Ingeborg Bevensee Canavati Dentist. Oral Rehabilitation Specialist. Research Associate, Universidad de Chile, Santiago, Chile. , Ana Beatriz Silva Lopes PhD in Dental Sciences. Assistant Professor, School of Dentistry and Rehabilitation Sciences, Universidad San Sebastián, Santiago, Chile. , Jorge Gamonal PhD in Dental Sciences. Full Professor, School of Dentistry, Center for Epidemiology and Surveillance of Oral Diseases (CEVEO), Universidad de Chile, Santiago, Chile.

Received: 28 August 2025, Accepted: 23 February 2026, Published: 26 March 2026

https://doi.org/10.18294/sc.2026.5911

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Abstract

The article analyzes how tooth loss among older adults is not merely a clinical issue but a social and emotional phenomenon marked by shame, stigma, and structural inequality in oral health in Chile. From a qualitative, narrative approach with a descriptive scope and a hermeneutic (interpretive) orientation, 12 interviews were conducted in the commune of Cerro Navia, in the Metropolitan Region of Chile, between August and September 2024. The narratives reveal that tooth loss affects self-esteem, identity, and social participation. Shame manifests in behaviors such as covering the mouth, avoiding smiling, speaking in public, or attending social gatherings, leading to social isolation and psychological suffering. The testimonies show that lack of financial resources and limited access to public dental care exacerbate this distress, forcing many individuals to resign themselves to tooth loss. This condition, in addition to limiting nutrition and everyday functioning, becomes a social marker of class, reinforcing moral judgments associated with poverty and poor hygiene. The study concludes that shame cannot be understood solely as an individual emotion, but rather as a social device that reproduces inequalities and exclusions. An integrated approach to oral health is proposed, ensuring equitable access to treatment, dignity, and quality of life, while recognizing its direct link to mental health.

Keywords: Mental Health, Shame, Oral Health, Tooth, Chile

Categories: Mental health, Healthcare models

Funding: Fondo de Fomento al Desarrollo Científico y Tecnológico | ID22I101

Full-text of the article is available for this language: Español.

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