This paper seeks to identify an important point of contact between the literature on inequalities in oral health and the sociology of power. The paper begins by exploring the problem of social inequalities in oral health from the point of view of human freedom. It then goes on to briefly consider why inequalities in oral health matter before providing a brief overview of current approaches to reducing inequalities in oral health. After this the paper briefly introduces the problem of power in sociology before going on to outline why the problem of power matters in the problem of inequalities in oral health. Here the paper discusses how two key principles associated with the social bond have become central to how we think about health related inequalities. These principles are the principle of treating everyone the same (the principle of autonomy) and the related principle of allowing everyone to pursue their own goals (the principle of intimacy). These principles are outlined and subsequently discussed in detail with application to debates about interventions to reduce oral health related inequalities including that of water fluoridation. The paper highlights how the 'Childsmile' programme in Scotland appears to successfully negotiate the tensions inherent in attempting to do something about inequalities in oral health. It then concludes by highlighting some of the tensions that remain in attempting to alleviate oral health related inequalities.