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

口腔健康状况影响咀嚼和说话等基本功能，并显著影响身心健康和生活质量，尽管作出了预防努力，但龋齿和牙周病仍然存在，影响到所有年龄段。生物学、生理和社会学因素，如年龄、健康状况和神经认知能力，进一步影响牙科护理的可及性和质量。老年人、儿童、年轻人和不同神经类型或身体残疾的个体面临系统性不平等，并经历口腔健康差异。本研究将关键包容性设计(CID)作为一种与当前口腔健康政策和系统向包容性和公平、以人为中心和预防保健过渡高度相关的方法。其目的是将口腔健康中的CID概念化和语境化，并为其未来的应用制定战略研究和政策议程。CID在现有的包容性设计领域取得了进展，该领域的重点是为人类多样性进行设计，力求创造对所有用户，特别是那些历史上被边缘化或排斥的用户可获得和包容的产品、服务和系统。通过批判性地识别和处理系统边缘的“极端”情景和背景，CID寻求促进整体理解，并使创新的系统过渡努力成为可能。在这样做的过程中，CID与塑造包容和排斥经验的更广泛的社会、文化和政治背景接触，有意在制度和政策层面运作，考虑权力动态、社会正义和系统性压迫等问题，并制定设计战略来挑战和破坏这些动态。研究方法包括三个不同的活动：(1)全面评估口腔健康景观的更广泛设计；(2)通过对“极端”的研究，将口腔健康中的CID概念化和语境化；(3)共同定义CID领导的英格兰西北部口腔健康政策和研究的议程。本研究综合运用系统绘图、多方利益相关者调查、访谈、社区参与及生成性研讨等方法，建立口腔健康网络中的口腔健康资讯系统，为促进口腔健康系统的包容性与公平性，提供一个基于口腔健康资讯系统原则的概念框架、方法及未来议程。这项研究的主要成果包括：口腔健康设计的互动证据地图；CID的理论框架；口腔健康系统中“极端”的定义、维度和故事；英格兰西北部CID在口腔健康方面的战略研究和政策议程。

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.