As an outcome metric, understanding the impact of oral disease and health on an individual centers the focus of dental care on treating patients as whole humans and emphasizes what they, the patient, ultimately value1,2. Oral health impact, often measured by instruments such as the Oral Health Impact Profile (OHIP), has previously been defined as “the patient-perceived impact of oral conditions and dental interventions”3. The use of oral health impact here is intentional as an effort to utilize the broadest term depicting a focal goal of dentistry as a profession – to reduce the negative impact or improve the positive impact of oral health on well-being. Oral health-related quality of life is perhaps a more commonly used term, but in general, incorporates aspects of patient perceptions of pain, function, psychosocial impact, and appearance3. As a biopsychosocial phenomenon, the use of oral health impact as an outcome coincides with long-standing calls for dentistry to be more person-centered and with efforts to move toward value-based care systems4. What lacks, however, are robust models or frameworks that help to explain the etiology and maintenance of oral health impact.

To establish itself as a truly person-centric discipline, the fields of dental, oral, and craniofacial research and practice must continue to embrace behavioral and social sciences as essential components to such an endeavor. Prior efforts to welcome and integrate behavioral and social sciences into dentistry have been fruitful over the years5. Standing on the shoulders of others, however, over 400 individuals and groups recently emphasized the continued need for such an integration in oral health via a consensus statement regarding the state and future directions of behavioral and social sciences6.

The consensus statement highlighted the need to identify theories that will facilitate the understanding of mechanisms connecting behavioral and social sciences phenomena to oral health and well-being. The statement likewise called for developing and testing behavioral and social interventions to promote oral health. What the statement did not outline, however, was how behavioral and social sciences are embedded in, and help to define, the very concept of “oral health.” Thus, this paper responds to the calls of the consensus statement and provides one possible theory or framework (the 3P model) for understanding behavioral and social sciences as centric to understanding 1) what oral health impact is, 2) how oral health impact develops, 3) how oral health impact is maintained, and 4) how oral health impact can be improved.