Two Years of Revolutionizing Oral Health in Tanzania: Evaluation of a Multicomponent Government-Led Model.

Background: In 2022, the Tanzanian government launched a comprehensive multicomponent reform aimed at revolutionizing the national oral health care system. This initiative is part of a broader commitment to align with global health standards and address the significant oral health challenges faced by the population. Prior to the reforms, Tanzania's oral health infrastructure was marked by outdated practices and high prevalence rates of oral diseases, including dental caries and periodontal disease. Methods: We employed a qualitative case study design, guided by Walt and Gilson's Policy Triangle and Kingdon's Multiple Streams Framework, to analyze the planning, implementation, and early outcomes of the reform. Data were sourced from national surveys, District Health Information System-2 (DHIS2), official policy documents, procurement and training reports, and triangulated across multiple systems. Analysis focused on reform milestones, service utilization trends, and contextual drivers. Results: The reform resulted in significant system-wide changes, including the procurement of 340 modern dental chairs, installation of 306 digital radiography units, and national phase-out of dental amalgam. An Oral Health Scorecard was deployed to monitor restorative treatment trends, contributing to a reduction in the extraction-to-restoration ratio from 2.8:1 in 2022 to 1.3:1 in 2025. The introduction of a pregnancy-focused oral health program and expanded training for dental therapists further enhanced service equity and quality. Reform implementation was enabled by strong political will, professional consolidation, and integration within existing national health strategies. Conclusion: Tanzania's rapid and multicomponent oral health reform represents a pioneering model for low- and middle-income countries. By aligning with the WHO Global Oral Health Action Plan and embedding oral health into primary and maternal healthcare, the country has laid the foundation for sustainable and equitable dental care. Continued investments in digital innovation, public-private partnerships, and health education will be critical for scaling impact.