Community dentistry and oral epidemiology最新文献

{"title":"Kā pao te tōrea: Opportunities to Improve Oral Health Services for Māori.","authors":"J Kuramaiki Lacey, Esther J Willing, Susan M Moffat, Kate C Morgaine","doi":"10.1111/cdoe.70114","DOIUrl":"https://doi.org/10.1111/cdoe.70114","url":null,"abstract":"<p><strong>Objective: </strong>Colonisation continues to shape Indigenous health outcomes today. Māori are the Indigenous people of Aotearoa New Zealand, and experience barriers to accessing care and a greater prevalence of dental caries, periodontal diseases, and tooth loss compared with non-Māori. This study investigated how Māori adults want oral healthcare services to be delivered in their community.</p><p><strong>Methods: </strong>Participants who lived in Rotorua (affiliated to Ngāti Whakaue hapū and Te Arawa iwi) were invited to a wānanga, facilitated by two Māori dental practitioners from the hapū, to explore experiences of services and barriers, and opportunities to improve oral health service delivery for Māori adults. Thematic analysis was conducted. Participant voices were centred to ensure that solutions were culturally responsive.</p><p><strong>Results: </strong>Seventeen whānau members participated. Five themes were identified: (1) childhood experiences influence engagement as adults; (2) culturally safe oral healthcare; (3) access to the Māori oral health workforce; (4) world-class iwi and hapū kaupapa Māori facility; and (5) iwi-led oral health data to drive service delivery. The themes highlighted an urgent need for changes in oral health service delivery for Māori communities, as well as the importance of Māori community strengths.</p><p><strong>Conclusion: </strong>Oral health services should deliver care in a culturally safe environment that upholds Māori knowledge and tikanga. There is a need for Māori-led dental services, as well as innovative approaches to grow the Māori oral health workforce. Evidence-based approaches are required to ensure that service delivery is responding to community realities. Iwi- and hapū-led data collection mechanisms could help to achieve this.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Oral Health Birth Cohort Studies: A Living Scoping Review.","authors":"Fernando Valentim Bitencourt, Shilpa Sarawagi, Silas Alves-Costa, Gustavo G Nascimento, Karen Glazer Peres","doi":"10.1111/cdoe.70108","DOIUrl":"https://doi.org/10.1111/cdoe.70108","url":null,"abstract":"<p><strong>Objective: </strong>In 2020, a scoping review mapped the existing Oral Health Birth Cohort Studies (OHBCS). Given the rapid growth and disparate nature of this field, this living scoping review aimed to identify new OHBCS and report their findings.</p><p><strong>Methods: </strong>A three-step search strategy was adopted. Studies were searched using the databases PubMed, Embase, Web of Science, and Scopus, along with the grey literature with no language restrictions. Two independent reviewers screened the studies. OHBCS included those with baseline data collection during pregnancy or within the first year of the child's life or linked future oral health data to exposures during either of these two life stages.</p><p><strong>Results: </strong>Of the 5374 records, 32 new OHBCS from 16 countries (Northern Ireland and Scotland as part of the UK), comprising 184 studies, were identified. These were categorized as OHBCS with a single oral health publication (n = 17), OHBCS with two or more oral health publications (n = 10), cohorts nested within interventional studies (n = 2) and data linkage cohorts (n = 3). Most of the OHBCS (66%) were established in very high Human Development Index (HDI) countries. OHBCS, with a single publication, included participants from birth to 15, with participation rates ranging from 14.6% to 100.0%. Similarly, those with two or more publications, nested interventions, or data linkage had participation rates ranging from 13.3% to 99.4% by age 6. The most commonly reported primary outcomes were dental caries (n = 18), enamel defect/hypomineralization (n = 9), and oral microbiome (n = 5).</p><p><strong>Conclusion: </strong>The review highlights the rapid growth of new OHBCs, particularly in very high-human development countries and identifies emerging approaches in genetics and microbiome research. Efforts should encourage new OHBCS in low- and middle-income countries and support engagement in pooled analyses. Initiatives by GLOBICS (Global Consortium of Oral Health Birth Cohort Studies) may help define critical actions to leverage new and well-established OHBCS.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meaningful Community Engagement-The Foundations of Global Oral Health Research.","authors":"Richard G Watt, Mirai Chatterjee, Michelle Stennett, Regina Mutave, Paulo Sávio Angeiras de Goes, Manu Mathur, Abhishek Mehta, Luis-Alberto Sánchez-Alfaro, Maria-Kamila Navarro Ramirez, Starry John D'Cruz, Susan Thomas, Rajeev Basapathy Rudrappa, Alastair Ross, David I Conway, Teddy Kyalo Kitili, Carolina Thaiza Costa Pazos, Carol C Guarnizo-Herreño","doi":"10.1111/cdoe.70102","DOIUrl":"https://doi.org/10.1111/cdoe.70102","url":null,"abstract":"<p><p>The global burden of oral diseases and shocking inequalities highlight the failure of current oral health systems and policies. One of the limitations with existing approaches is that they rely almost exclusively on professional perspectives with minimal input from communities, and in particular disadvantaged populations. As a consequence, interventions often fail to achieve sustained improvements and have limited impact in reducing inequalities. Within global health, there is growing recognition of the importance of meaningful community engagement in all aspects of policy, practice and research. The CORE global oral health research programme is being conducted in four middle-income countries (Brazil, India, Colombia and Kenya) and an innovative element is that the planned research will be informed by community engagement with disadvantaged communities. Through a process of co-design, local communities will be actively involved in designing, implementing and evaluating interventions. The planned community engagement activities include community mapping, establishment of community forums, appointment of community link workers and community outreach activities including visual and performing arts events. The aim of this commentary is to critically review the policy context and principles of community engagement, and to reflect on insights gained through the initial engagement activities undertaken as part of the CORE programme.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Our Community Needs More Information About Oral Health\": Co-Designing a Culturally Grounded Oral Health Promotion Training With Aboriginal Health Workers and Practitioners.","authors":"Madison Cachagee, Ashleigh Smith, Priscilla Larkins, Michael Larkin, Dandara Haag, Eleanor Parker, Emily Minh-An Bui, Lisa Jamieson, Brianna Poirier","doi":"10.1111/cdoe.70113","DOIUrl":"https://doi.org/10.1111/cdoe.70113","url":null,"abstract":"<p><strong>Objectives: </strong>Oral health is central to holistic wellbeing for Aboriginal and Torres Strait Islander Peoples, yet mainstream promotion approaches often rely on individualistic models that fail to reflect Community realities. Aboriginal Health Workers and Practitioners (AHW/Ps), as trusted Community members and the only nationally registered culturally based health profession, are uniquely positioned to embed oral health within relational models of care. Despite this strength, oral health remains absent from mandatory AHW/P training and continuing professional development. This paper aims to document the co-design of a culturally grounded oral health promotion training with AHW/Ps across Aboriginal Community Controlled Health Organisations (ACCHOs) in South Australia.</p><p><strong>Methods: </strong>Guided by Indigenous research methodologies, Critical Race Theory and principles of relationality, this project partnered with three ACCHOs in South Australia. The process was governed by an Aboriginal-led Project Governance Committee (PGC) and centred on Yarning sessions, annotated worksheets and iterative feedback loops with AHW/Ps, clinic staff and Community leaders.</p><p><strong>Results: </strong>A total of 34 staff across the three ACCHOs, including AHW/Ps and other clinic team members, contributed to the co-design. Participants prioritised oral health topics relevant to everyday practice. These insights shaped a training package comprising knowledge and practical components, supported by culturally relevant visuals, character-based videos and site-specific referral pathways.</p><p><strong>Conclusion: </strong>The co-design process itself was a key outcome, strengthening relationships, trust and Community leadership. Effective oral health promotion must move beyond extractive models toward approaches grounded in Indigenous knowledge, reciprocity and structural change. By centring AHW/Ps, the training supports Community-led health promotion and Aboriginal and Torres Strait Islander self-determination in oral health.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screen Time, Juice Consumption, Caregiver-Assisted Toothbrushing and Dental Caries at Age 3 Years: A Population-Based Cohort Study in Japan.","authors":"Toshifumi Yodoshi","doi":"10.1111/cdoe.70112","DOIUrl":"https://doi.org/10.1111/cdoe.70112","url":null,"abstract":"<p><strong>Objectives: </strong>To examine whether screen time at age 3 years was associated with dentist-assessed dental caries, and whether regular juice consumption modified this association.</p><p><strong>Methods: </strong>This population-based retrospective cohort used linked municipal child health records at 18 months and 3 years in Okinawa, Japan (2014-2019). The outcome was any dental caries at age 3 years. Exposures were caregiver-reported screen time (≤ 1, 1-2, > 2 h/day), regular juice consumption, caregiver-assisted toothbrushing and breastfeeding at 18 months. Adjusted risk ratios (aRRs) were estimated by modified Poisson regression, adjusting for demographic, household, sleep, dietary and routine factors and baseline caries. Effect modification by regular juice consumption was assessed on multiplicative and additive scales; multiple imputation addressed missing data.</p><p><strong>Results: </strong>Among 60 404 children, 15 608 (25.8%) had caries at age 3 years; of 58 815 caries-free at 18 months, 14 269 (24.3%) developed it. Screen time > 2 h/day carried higher caries risk than ≤ 1 h/day (aRR 1.08; 95% CI 1.04-1.12). Regular juice consumption was strongly associated (aRR 1.32; 1.28-1.35), whereas caregiver-assisted toothbrushing was protective (0.66; 0.64-0.68). The association was modified by regular juice consumption: among non-consumers, aRRs were 1.07 (1.03-1.11) and 1.13 (1.08-1.18) for 1-2 and > 2 h/day, versus 0.98 and 1.00 among regular consumers; the joint association was sub-additive. Multiple-imputation analyses were similar.</p><p><strong>Conclusions: </strong>Higher screen time was modestly associated with caries, whereas regular juice consumption and absence of caregiver-assisted toothbrushing were major correlates; the screen-time association was most evident among children without regular juice consumption. Prevention may need to address screen-related routines alongside dietary and oral hygiene practices.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Barriers and Facilitators Influencing Oral Health Behaviours of Families of Autistic Children: A Scoping Review.","authors":"Amrit Chauhan, Helen Wilson, Peter Day, Kara Gray-Burrows, Kathy Leadbitter, Sarah Baker, Zoe Mashman, Nicola Pickles, Karen Vinall-Collier","doi":"10.1111/cdoe.70098","DOIUrl":"https://doi.org/10.1111/cdoe.70098","url":null,"abstract":"<p><strong>Objectives: </strong>To identify barriers and facilitators to home-based oral health behaviours in families of autistic children, using the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation-Behaviour (COM-B) model.</p><p><strong>Methods: </strong>A scoping review was conducted using Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Seven databases were searched up to March 2024. Eligible studies focused on parental views of oral health behaviours (toothbrushing and sugar reduction) for autistic children up to 18 years. Data were charted and mapped to the COM-B model and the Theoretical Domains Framework (TDF).</p><p><strong>Results: </strong>Seventeen studies were included across various countries including the USA, Hong Kong and Saudi Arabia. A total of 93 barriers and 81 facilitators were identified. Most identified influences related to the COM-B 'Opportunity' domain. Key domains were 'Environmental Context and Resources', 'Skills', 'Emotion', 'Social Influences', and 'Reinforcement'. Common barriers included sensory sensitivities, emotional strain, and skill challenges. Facilitators included environmental adaptations, support from professionals, and routine-building. Dietary behaviours related to reducing sugary foods and drinks were rarely explored. Some behavioural domains (e.g., identity, optimism) were not represented.</p><p><strong>Conclusions: </strong>This review provides a conceptually robust synthesis of modifiable behavioural influences on oral health in autistic children, grounded in parent/carer perspectives. It highlights critical gaps, especially the underrepresentation of sugar-related dietary behaviours, alongside the need for adapted behavioural frameworks and greater evidence from diverse contexts beyond the USA. Findings contributed to the development of toothPASTE, a co-designed intervention, and illustrate the broader potential of scoping reviews to bridge evidence and practice in developing inclusive, theory-informed strategies for neurodivergent populations.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Childhood Caries and Maternal Education: Systematic Review and Meta-Analysis.","authors":"Roger Keller Celeste, Mariel de Aquino Goulart, Elisa Coelho, Heber Arbildo, Rita Villena, Moréniké Oluwátóyìn Foláyan, Carlos Alberto Feldens","doi":"10.1111/cdoe.70110","DOIUrl":"https://doi.org/10.1111/cdoe.70110","url":null,"abstract":"<p><strong>Objectives: </strong>To review and synthesise the available evidence on the association between maternal education and early childhood caries (ECC).</p><p><strong>Methods: </strong>A comprehensive search strategy was employed to identify relevant studies published up to September 2025. Databases searched were PubMed, Scopus, Web of Science, and EMBASE. Authors of selected studies were contacted for additional information and to search for unpublished studies. A rigorous screening of publications was conducted, and data were extracted independently by two reviewers. All analytical study designs were included without language or year of publication restriction. The risk of bias was assessed using the Newcastle-Ottawa guidelines. Random-effects stratified meta-analyses were conducted to estimate the pooled odds ratio (OR). Meta-regression was carried out to assess potential factors associated with heterogeneity, such as study design, diagnostic criteria, sample characteristics, community fluoridation programmes, country economic indicators, and social policies.</p><p><strong>Results: </strong>The search retrieved 5562 unique articles and 155, conducted in 44 different countries, were included after full-text reading. The majority were cross-sectional (n = 124), followed by cohort (n = 24) and case-control (n = 7). The diagnostic criteria for dental caries varied across studies: 116 reported cavitated lesions, 39 included noncavitated lesions. The pooled effect showed that children of mothers with lower education had significantly higher chances of developing ECC compared to those of mothers with higher education: OR = 1.82 (95% CI 1.65-2.02 I²: 88.8%). Neither study characteristics nor country of dataset were able to significantly explain heterogeneity (p > 0.05), although the association was stronger among High-Income countries (OR = 1.92) than among Lower-Middle-Income countries (OR = 1.61) and among the highest tertile of social spending (OR = 1.98) than the lowest tertile (OR = 1.63). Social spending explained 3% of heterogeneity, all other explained less than 1% or nearly zero.</p><p><strong>Conclusion: </strong>Maternal education is a consistent risk factor for ECC regardless of study characteristics.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Mid-Level Dental Providers in Iran: Challenges and Opportunities.","authors":"Homa Fathi, Tayebe Rojhanian, Ali Kazemian, Ian Litchfield, Vahid Ravaghi","doi":"10.1111/cdoe.70109","DOIUrl":"10.1111/cdoe.70109","url":null,"abstract":"<p><strong>Objectives: </strong>The WHO Global Strategy and Action Plan on Oral Health 2023-2030 encourages innovative approaches such as shifting tasks from dentists to Mid-level Dental Providers (MLDPs), who work independently to improve access to and equity in oral health. This study aimed to examine stakeholders' perspectives on the challenges and opportunities associated with introducing MLDPs in Iran.</p><p><strong>Methods: </strong>A qualitative descriptive approach was adopted. Guided by the Consolidated Framework for Implementation Research (CFIR), semi-structured interviews were conducted with 10 stakeholders selected through an informant-based sampling strategy. Interviews were transcribed verbatim and analysed thematically.</p><p><strong>Results: </strong>Stakeholders widely acknowledged the need for MLDPs but disagreed on their scope. Some supported limiting their role to preventive services, while others argued for including essential clinical tasks. Participants recognised that Iran has a legal basis for introducing MLDPs, though some criticized its \"career transition\" pathway which allowed dental therapists entry into dental programmes. Rural communities and primary health care facilities perceived as receptive to dental therapists, though infrastructure gaps persist. Implementation was considered as dependent on ministry and non-ministry actors.</p><p><strong>Conclusions: </strong>The findings highlight both opportunities and challenges associated with introducing MLDPs in Iran. The introduction of MLDPs is hindered by professional protectionism and power dynamics that prioritise dentists' interests over public needs, as well as infrastructural weaknesses. Overcoming these barriers will require redistributing decision-making power. This can be advanced through participatory research approaches and public engagement to promote the inclusion of community voices.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Disability in Oral Health Policy and Practice in the UK.","authors":"K Rijhwani, J E Gallagher, S Scambler","doi":"10.1111/cdoe.70106","DOIUrl":"https://doi.org/10.1111/cdoe.70106","url":null,"abstract":"<p><strong>Objectives: </strong>In the United Kingdom (UK), disabled people face barriers accessing dental care, leading to poor oral health. To understand these barriers, the present study examined how disability is defined and conceptualised in UK oral health policy documents, and explored the implications of these framings for the provision of dental care for disabled people.</p><p><strong>Methods: </strong>A qualitative documentary analysis was conducted using a seven-phase framework. Oral health policy documents published between 2000 and 2023 were identified through targeted website searches, supplementary web searches and consultation with an expert panel. Twenty-six national and international documents were included. Data were extracted using a structured matrix and analysed using a directed approach informed by the social model of disability. Coding was organised into three themes: disability terminology, underlying models of disability and vision for oral healthcare.</p><p><strong>Results: </strong>Of the 26 documents analysed, 15 provided explicit definitions of disability, predominantly within Special Care Dentistry (SCD) guidance, while general oral health documents rarely defined the term. Most general dental policies adopted a medical model, focusing on individual impairments, whereas SCD and international documents were more likely to incorporate social or biopsychosocial approaches. Consideration of barriers to care, infrastructure requirements and workforce competencies was inconsistent and largely absent from general dentistry documents. A clear, system-wide vision for the provision of inclusive oral healthcare for disabled people was evident in only a small number of documents.</p><p><strong>Conclusions: </strong>UK oral health policy documents demonstrate inconsistent and often limited conceptualisations of disability, with a predominance of medical model approaches in general dentistry. The lack of clear definitions and absence of barrier-focused frameworks may contribute to ongoing inequalities in access to and outcomes of dental care for disabled people. Greater explicitness in defining disability, alongside the adoption of inclusive, barrier-oriented policy frameworks and increased attention to workforce development and service design, is required to support equitable and accessible oral healthcare.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financing, Coverage and the Structural Gaps in Universal Oral Health Provision for Older Adults: A Cross-Country Review.","authors":"Manu Raj Mathur, Shehnaz Khan, Viswa Chaitanya Chandu, Noha Gomaa, Ankur Singh, Georgios Tsakos","doi":"10.1111/cdoe.70103","DOIUrl":"https://doi.org/10.1111/cdoe.70103","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate health system readiness for UHC for oral health in ageing populations, using a cross-country analysis of eight countries (Japan, India, Colombia, Rwanda, the UK, Nigeria, Australia, Canada). The analysis encompasses health system organisation, financing and service delivery; dental workforce volume and distribution; oral health policies and provisions for older adults; and age-based differences in oral disease burden.</p><p><strong>Methods: </strong>A narrative review was conducted across eight countries, purposively selected to represent diverse health system financing and governance arrangements using three established health system frameworks, by Böhm et al., Mackintosh et al. and Karan et al. Data were sourced from the WHO Global Oral Health Status Report and supplementary country-specific sources, and findings were organised thematically across four domains. Age-based differences in oral disease burden were quantified using disability-adjusted life years (DALYs) rates per 100 000 population, comparing adults aged ≥ 65 years with those aged < 65 years over the period 2001-2021, with both absolute and relative differences calculated.</p><p><strong>Results: </strong>Considerable variation in readiness towards achieving UHC for oral health in ageing populations was observed. High-income countries nominally included essential dental services under UHC but often with shallow coverage, significant co-payments and limited rehabilitative services, leading to substantial out-of-pocket spending (notably Australia and Canada). Lower-income countries provided minimal public financing for oral health, leaving most dental care to private out of pocket expenditure (as observed in India and Nigeria). Dental workforce shortages and maldistribution were pronounced in low-resource settings (Rwanda and Nigeria recorded dentist-to-population ratios of approximately 1:57000 and 1:35000 respectively). Few countries had specific policies or programmes targeting oral healthcare for older adults (Japan and the UK). In most countries, adults ≥ 65 years had a higher oral disease burden than younger adults, especially in contexts with lower overall disease levels and greater longevity.</p><p><strong>Conclusions: </strong>Health systems are largely underprepared to deliver adequate coverage for oral health services for ageing populations. Strengthening financial protection, broadening coverage of preventive and restorative dental services, enhancing workforce capacity and embedding oral health in general health and ageing policies are critical to achieving equitable oral health outcomes for older adults.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}