Inclusive Design for Future Oral Health Scenarios; A lifespan design approach investigating mainstream and extreme oral health pathways I

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Oral health status impacts basic functions like chewing and speech, and significantly influences physical and psychosocial well-being and quality of life, Despite preventive efforts, dental caries and periodontal disease persist, affecting all age groups. Biological, physical, and sociological factors such as age, health status, and neuro-cognitive ability further influence dental care access and quality. Subgroups like older adults, children, young adults, and neurodiverse or physically disabled individuals face systemic inequalities and experience oral health disparities.This research advances Critical Inclusive Design (CID) as an approach which is highly relevant to current oral health policy and systems transitions towards inclusion and equity, person-centred and preventive care. The aim is to conceptualise and contextualise CID in oral health and set a strategic research and policy agenda for its future application. CID advances on the established field of inclusive design, which centres on designing for human diversity, seeking to create products, services, and systems that are accessible and inclusive for all users, particularly those who have been historically marginalised or excluded. By critically identifying and engaging with 'extreme' scenarios and contexts at the periphery of a system, CID seeks to foster holistic understanding and enable innovative system transition efforts. In doing so, CID engages with the broader social, cultural, and political contexts that shape experiences of inclusion and exclusion, intentionally operating on a systems and policy level, considering issues such as power dynamics, social justice, and systemic oppression, and developing design strategies to challenge and disrupt these dynamics. The research methodology consists of three distinct activities: (1) comprehensive assessment of the wider design in oral health landscape; (2) conceptualisation and contextualisation of CID in oral health through a study of 'extremes'; (3) co-defining a CID-led agenda for oral health policy and research in North West England. A combination of methods including systematic mapping, multi-stakeholder surveys, interviews, community engagement and generative workshops are employed, and CID in oral health network is established.This research contributes to advancing inclusive and equitable oral health systems through providing a conceptual framework, methods and future agenda grounded in CID principles. Key outcomes of the research include: an interactive evidence map of design in oral health; a theoretical framework of CID; definitions, dimensions and stories of 'extremes' in oral health systems; a strategic research and policy agenda for CID in oral health in North West England.