Background/Objective:
The social determination of the health-disease process (SDHDP) approach, differing from the widespread approach on social determinants of health, understands health articulated with social/historical processes. It takes social formation and organization, and their consequences on the population as fundamental for reality analysis. SDHDP approach leads to the questioning of the need for social/systemic change for health promotion, aiming at a society without unjust and avoidable inequalities. The objective of this study is to produce reflections on racial inequities in indigenous peoples oral health from the perspective of the SDHDP approach.

Methods:
A critical essay on the themes of oral health of indigenous peoples, racial inequities in health, and the SDHDP approach was conducted. Notes on the articulation of the themes are presented and debated.

Results:
Several countries built on colonial legacies of slavery, exploitation, and racialization present an intense and violent profile of racial inequalities in health, framed as health inequities, intrinsically linked to the inability to treat the avoidable, unjust, and oppressive historical-political process denominated by racism. It overcomes discrimination at the individual level, reaching institutional and structural expressions. Oral health inequities among indigenous peoples are high in several countries, with a solid relationship between the implementation of neoliberal policies, racism, and the increase in social inequalities, with more indigenous communities living in poverty.

Conclusion:
Discussions on the racialized/indigenous peoples health need to incorporate the impacts of a colonialist legacy that acts via political/social processes. Racism impacts general and oral health. It is essential to overcome the methodological approach to racism as a simple risk factor, moving to understand it as a multilevel oppression system with structural, institutional, and cultural dimensions. The oral health field allows a distinct look at social injustices since it reflects unequal material circumstances and healthcare access, and structural inequities throughout life.