Oral Health & Dental Care

Skip anything

Every question is optional. No one has to retell painful events, name a diagnosis, or choose a religion or identity to begin.

Pause or stop

Stop at any point. Nothing is sent anywhere, and nothing is shared unless the person chooses it in the sharing review.

Whose words

Record who said each thing: the person, a caregiver or surrogate, or a professional. A caregiver's needs get their own field.

Support to take part

Extra time, a quieter place, pictures, an interpreter or a trusted person can help someone say what matters. Ask what helps.

Barriers are not preferences

Cost, travel, work, housing, caring for others and digital access are written down as barriers, not as what the person wants.

Meaning, religious or not

Hope, purpose, faith, relationships and identity can be part of the conversation if the person wants. None is assumed.

• Dentist: Options, costs and what each involves.
• Dental hygienist or therapist: Cleaning, prevention and daily care.
• Nurse or care worker: Help with mouth care at home or in a care home.
• Social worker: Costs, coverage and getting to appointments.
• Chaplain or spiritual-care provider: Meaning, distress, hope and relationships, for people of any faith or none.
• Interpreter or communication specialist: Language and communication support so the person's own words come through.
• People the person chooses: Family, friends, or a community or faith contact, only if the person wants them. Never assumed safe, available or wanted.

Roles, titles and training differ by country and service. Not every role exists everywhere.

A small set of places chosen for contrast, not a ranking or a representative survey: Global, Uganda, Tanzania, Belgium, Chile, United States, Saudi Arabia, India, Malaysia, Australia. Each example states what its source establishes and what it does not. Policy on paper is not proof that a service is available.

• Global · Measured outcome · 2022

  WHO's 2022 oral health status report describes a WHO-led study in 78 countries finding that, in most low-income countries surveyed, a year's fluoride toothpaste on a lowest-paid government worker's income exceeded the catastrophic expenditure threshold.

  What others could learn: Cost can shape everyday mouth care, not only treatment. The same report says out-of-pocket costs can be major barriers, because services are often only partly or not at all covered, so people pay the entire cost or substantial copayments.

  Conditions, limits and source

  Conditions that matter:

  Affordability depends on wages, retail prices and whether governments treat fluoride toothpaste as an essential product. The report quotes the WHO Director-General's report on oral health calling for legislation to increase the affordability and accessibility of high-quality fluoride toothpaste.

  Cannot be inferred:

  Does not show how often people go without toothpaste or what that means for their oral health. Does not name the countries assessed. Does not describe the cost of dental treatment.

  Limits:

  Rests on a box summary inside a WHO report; the underlying affordability study was not read, and its country list, prices and collection dates were not extracted. Affordability is measured against one reference wage, not household budgets.

  Source: World Health Organization, Global oral health status report: towards universal health coverage for oral health by 2030 (Section 3 'Challenges and opportunities towards oral health for all', Box 14 'Affordability of essential medicines: the case of fluoride toothpaste in 78 countries', printed p. 67 (PDF p. 85); out-of-pocket text used in the lesson at printed p. 28 (PDF p. 46)). Where: Global (78 countries). Population: People living on the reference income of the lowest-paid unskilled government worker, across 78 countries. Published 2022-11-17; retrieved 2026-10-12.

• Global · Guidance · 2024

  WHO's global strategy on oral health (WHA75(11), 2022), annexed to the 2023-2030 action plan, says people-centered oral care seeks and engages the perspectives of individuals, families and communities, including people affected by poor oral health.

  What others could learn: The same paragraph says people-centered care fosters needs assessment, shared decision-making and oral health literacy, and that health systems respond to people's needs and preferences in humane and holistic ways. The action plan also asks that oral health decision-making engage people living with oral diseases, special care needs or disabilities.

  Conditions, limits and source

  Conditions that matter:

  Assumes oral health care is integrated into primary health care and universal health coverage, with a workforce trained in prevention, inter-professional communication and people-centered care. WHO's 2022 status report notes services are often only partly or not at all covered by government programs or insurance.

  Cannot be inferred:

  Does not show that any country delivers people-centered oral care. Does not describe what individuals want from oral care. Not a clinical guideline for any treatment.

  Limits:

  A global strategy for Member States, not an evaluation of any service. It does not describe how a clinician should gather a person's perspective in a visit, or what happens when the person's and the team's views differ.

  Source: World Health Organization, Global strategy and action plan on oral health 2023-2030 (Annex 1 'Global strategy on oral health WHA75(11)', Guiding principles, Principle 4 'People-centred oral health care', paragraph 27, printed p. 78 (PDF p. 89); groups disproportionately affected from Background, paragraph 4, printed p. 2 (PDF p. 13)). Where: Global. Population: People affected by oral diseases and conditions, including groups the strategy says are disproportionately affected, such as people living with disability and older people living alone or in care homes. Published 2024-04-30; retrieved 2026-10-12.

• Uganda · Reported experience · 2024

  In interviews with 15 people with no natural teeth attending a university dental hospital in Kampala, respondents described difficulty eating certain foods, trouble speaking, changed facial appearance, lost self-confidence in public and a sense of incompleteness.

  What others could learn: Tooth loss can touch eating, speech, appearance and confidence at once, so a care conversation could ask which matters most to the person. Respondents said family members gave emotional support or urged them to visit a dentist for dentures.

  Conditions, limits and source

  Conditions that matter:

  Complete dentures were available through the hospital's prosthetic laboratory. The authors say treatment costs strongly affect use of oral health services in Uganda and call for financing options for people with low socio-economic status. Most respondents first managed tooth pain with self-medication and home remedies.

  Cannot be inferred:

  Does not measure how common these experiences are among people with tooth loss in Uganda. Does not show whether dentures resolved the concerns. Does not describe people who cannot reach a dental hospital.

  Limits:

  Single site and small sample (15 people). All respondents had already sought complete dentures, so people who never reached care are not represented. The passage is the authors' summary of respondents' accounts. The interview language was not checked.

  Source: BMC Oral Health (Nono D, Bagenda G, Okullo I, Rwenyonyi CM), Exploring lived experiences with tooth loss among fully edentulous patients attending Makerere University Dental Hospital, Kampala, Uganda. (Discussion, full text (PMC11546535); the abstract Conclusion lists pain, eating difficulties, speech difficulties, poor facial appearance and low self-esteem). Where: Uganda (Makerere University Dental Hospital, Kampala). Population: 15 adults with complete tooth loss who wore removable complete dentures; 8 women; 13 aged 41 or older. Published 2024-11-07; retrieved 2026-10-12.

• Tanzania · Measured outcome · 2018

  In a willingness-to-pay survey of 1,522 outpatients at four Tanzanian regional hospitals, published in 2018, mean stated amounts were higher for tooth fillings than extractions; the authors read this as a preference for fillings.

  What others could learn: What people say they would choose can differ from the care they receive. Mean willingness to pay for fillings was below the average fees charged, so cost is one possible reason the two differ; a conversation could ask about both preference and affordability.

  Conditions, limits and source

  Conditions that matter:

  Stated amounts varied by age, income, outpatient status and previous experience with dental services; the youngest adults (18-24) and those with high income had higher odds of high valuations. Restorative services were limited in this population, per the title.

  Cannot be inferred:

  Does not show which treatment people received or why. Does not establish preferences outside these four hospitals. Money values are from the study period, not current prices.

  Limits:

  Abstract only; the publisher site and doi.org were unreachable. Willingness to pay is stated and hypothetical, not actual payment or treatment received. The abstract does not give survey dates. The authors note a gap between stated preferences and use of dental services.

  Source: Community Dental Health (Nyamuryekung'e KK, Lahti SM, Tuominen RJ); abstract via PubMed, Patients' willingness to pay for dental services in a population with limited restorative services. (Abstract, Conclusions (Community Dent Health 2018;35(3):167-172)). Where: Tanzania (four regional hospitals). Population: 1,522 adult outpatients at four regional hospitals. Published 2018-08-30; retrieved 2026-10-12.

• Belgium · Reported experience · 2024

  In interviews with 22 residents of three Flemish nursing homes, almost all said, when asked, that the mouth mattered to their well-being, citing appearance, eating and chewing, talking, feeling clean and being free of pain.

  What others could learn: Residents valued autonomy, and some were reluctant to ask for extra help with daily oral care. Asking what the mouth means to the person, and how they want help offered, can respect that independence. Some residents voiced fears about dental treatment or its costs.

  Conditions, limits and source

  Conditions that matter:

  Depends on care staff time and training and on links with dentists and dental hygienists; the authors identify loss of independence as a barrier to visiting the dentist. The study used the Oral Health Impact Profile (short form) and the interRAI oral health section, named here only.

  Cannot be inferred:

  Does not represent all nursing home residents in Belgium. Does not show that asking about priorities improves oral hygiene. Does not show the views of residents who could not be interviewed.

  Limits:

  Three nursing homes in one region and a small sample (22 residents); the authors say results cannot be generalized to all care-dependent older people in nursing homes. Residents' views differed from clinical findings: 77.3% reported satisfaction with their oral health while 86.4% had poor oral hygiene.

  Source: International Journal of Nursing Studies Advances (Vandenbulcke PAI, de Almeida Mello J, Cornette V, et al.; KU Leuven), Nursing home residents' perspectives on oral health: An in-depth interview study. (Results, section 3.3.2 (COM-B), 'Professional oral care', Motivation, full text (PMC11080337); satisfaction and hygiene figures from the abstract Results). Where: Belgium (three nursing homes, Flanders). Population: 22 nursing home residents purposively sampled for variation in oral status and cognitive performance. Published 2024-04-11; retrieved 2026-10-12.

• Chile · Reported experience · 2025

  In 15 interviews at one hospital palliative care unit in Valdivia, Chile, patients, caregivers and health professionals recognized oral health as important to quality of life and saw adding dental professionals to the team as necessary but challenging.

  What others could learn: Mouth care near the end of life matters to patients and families as well as clinicians. Palliative care conversations can include mouth comfort and access to dental care, with the dental professional's role agreed within the team.

  Conditions, limits and source

  Conditions that matter:

  Needs dental professionals who can join or reach the palliative team, and palliative staff with oral health training; the abstract lists barriers to dental care and oral health training of palliative care professionals among its themes.

  Cannot be inferred:

  Does not show how many palliative patients in Chile have oral problems or receive dental care. Does not show which barriers matter most. Not evidence that a dental team member improves comfort.

  Limits:

  Abstract only; the publisher site and doi.org were unreachable. Single site and small sample, with only four patients. The abstract names themes, including barriers to dental care, but does not describe them. The interview language is not stated in the abstract.

  Source: Gerodontology (Gambetta-Tessini K, Torre Silva MJ, De Marchi RJ, Vera Riquelme V, León S); abstract via PubMed, Oral Health Needs and Expectations in a Palliative Care Unit-A Qualitative Study. (Abstract, Conclusion (Gerodontology 2026;43(2):190-197); participant numbers from abstract Results). Where: Chile (Hospital Base of Valdivia). Population: 4 patients, 4 caregivers and 7 health professionals in a palliative care unit. Published 2025-12-17; retrieved 2026-10-12.

• United States · Measured outcome · 2025

  Adults with disabilities answering the 2022 US National Survey on Health and Disability most commonly cited underinsurance as a barrier to dental care, and also highlighted lack of accommodation, dental anxiety and difficulty securing appointments.

  What others could learn: Barriers to dental care for people with disabilities include accommodation and fear as well as cost. A conversation can ask what adjustments the person needs and whether dental visits cause anxiety, alongside questions about coverage.

  Conditions, limits and source

  Conditions that matter:

  Depends on dental insurance coverage, accessible clinics, appointment availability and providers willing to serve people with disabilities; the authors report participants' perception that dental providers are unwilling to serve them.

  Cannot be inferred:

  Does not give how common each barrier is. Does not show which accommodations help. Does not describe children with disabilities.

  Limits:

  Abstract only; PMC holds an HHS author manuscript whose full text could not be downloaded, and the publisher site was unreachable. The abstract gives no sample size or rate of unmet need. Respondents may not represent all adults with disabilities. One author serves on the journal's editorial board.

  Source: Disability and Health Journal (Diaz MA, Wood EG, Yuan W, Gimm G, Kennedy J); abstract via PubMed, Assessing unmet need for dental care from the perspective of adults with disabilities: A mixed methods approach. (Abstract, Results (Disabil Health J 2025;18(4):101835)). Where: United States (2022 National Survey on Health and Disability). Population: Adults with disabilities responding to the 2022 National Survey on Health and Disability. Published 2025-04-02; retrieved 2026-10-12.

• Saudi Arabia · Measured outcome · 2026

  In a convenience sample of 401 adult students and employees at one Riyadh university, the authors found dental anxiety highly prevalent; negative past dental experiences were the most frequently cited triggers.

  What others could learn: Fear can rest on past experiences of dental care. Asking whether earlier visits were distressing, and what would help now, can open a conversation before treatment options are discussed.

  Conditions, limits and source

  Conditions that matter:

  In this sample, female gender, a history of negative dental experiences and possible exposure to anxiety-provoking dental content on social media were associated with dental fear and anxiety.

  Cannot be inferred:

  Does not show how many people avoid or delay dental care because of fear. Does not show that any intervention reduces fear. Does not describe people outside a university setting.

  Limits:

  Abstract only; the publisher site and doi.org were unreachable. Single university and a convenience sample, so not representative of adults in Saudi Arabia. Self-reported questionnaire. The link with social media exposure is cross-sectional and cannot show cause.

  Source: International Journal of Dental Hygiene (Alotaibi RN, Alarifi L, Mahzari R, Alsalule S); abstract via PubMed, The Prevalence and Predictors of Dental Fear and Anxiety Among Adults in Riyadh, Saudi Arabia: A Cross-Sectional Study. (Abstract, Conclusion (Int J Dent Hyg 2026;24(4):838-845)). Where: Saudi Arabia (King Saud University, Riyadh). Population: 401 adult students and employees aged 18 and older. Published 2026-04-10; retrieved 2026-10-12.

• India · Service in operation · 2021

  A dental college in Mangalore began a program in 2016 bringing residents of one long-term care home to the college for dental care; in an evaluation, almost all 19 stakeholders, including 12 residents, reported satisfaction.

  What others could learn: Transport can decide whether care home residents reach dental care at all. The authors note that without the program's transport, residents would have had to travel to receive dental care at their own expense.

  Conditions, limits and source

  Conditions that matter:

  Requires a partner dental institution, scheduled transport, allotted treatment time and support staff; the college coordinator suggested a single window for treatment and more support staff. Most residents speak Kannada, so the questionnaire was translated.

  Cannot be inferred:

  Does not show changes in residents' oral health. Does not show the program still operates. Does not represent long-term care across India.

  Limits:

  Single facility and a small sample (19 stakeholders, 12 residents); descriptive statistics only. The authors say structured questionnaires limited exploration beyond set questions. Authors are affiliated with the college that runs the program. Satisfaction is not a clinical outcome.

  Source: Clinical, Cosmetic and Investigational Dentistry (Rao S, Shenoy R, Karat D, Poojary D, D'Souza V), Evaluation of Dental Program for Older Adults Living in Long-Term Care Facilities. (Abstract, Results (also in PMC8255310); transport and limitations text from the full-text Discussion). Where: India (Mangalore, Karnataka). Population: Older adults living in one long-term care facility; 19 stakeholders: 12 residents, 2 transport staff, 2 coordinators and 3 administrators. Published 2021-06-29; retrieved 2026-10-12.

• Malaysia · Service in operation · 2021

  In focus groups with 77 students aged 14 and 16 at three Selangor secondary schools, students said Malaysia's School Dental Service let them have checkups and treatment without visiting outside clinics and reduced possible treatment-cost burdens.

  What others could learn: Checkups at school spare travel and time away from class, and free care can lower cost barriers for families with low incomes. Students also wanted examinations that did not feel rushed and health education that held their interest.

  Conditions, limits and source

  Conditions that matter:

  All students in Malaysian government schools receive free annual dental checkups and treatment from age 7 to 17, per the authors; parental consent is obtained each school year. Large student numbers require enough dental staff.

  Cannot be inferred:

  Does not measure oral health outcomes. Does not describe students' views outside Selangor or in excluded school types. Does not show how parents view the service.

  Limits:

  Three schools in one state; students' views only. Vernacular, single-gender and boarding schools were excluded. Students also reported weaknesses: rushed examinations, infrequent and less interesting oral health education, and poor attitude of some service personnel.

  Source: BMC Oral Health (Ab Mumin N, Yusof ZYM, Marhazlinda J, Obaidellah U), Exploring the opinions of secondary school students on the strengths and weaknesses of the school dental service in Selangor, Malaysia: a qualitative study. (Abstract, Results (also in PMC8359023); sample, weaknesses and service details from the full-text Methods, Results and Background). Where: Malaysia (three government secondary schools, Selangor). Population: 77 government secondary school students aged 14 and 16 from the Malay, Chinese and Indian ethnic groups. Published 2021-08-11; retrieved 2026-10-12.

• Australia · Reported experience · 2025

  In interviews with 136 Indigenous adults in South Australia who took part in a dental care study, participants reported discrimination, fear and limited access to dental care because of cost or location.

  What others could learn: Participants named enablers of culturally safe dental care: continuity of care, Indigenous-led dental services, mobile services and at-home care, trauma-informed clinics, early intervention, oral health promotion, and free or low-cost care.

  Conditions, limits and source

  Conditions that matter:

  The authors report that dental care remains costly and regional areas remain underserviced. They call for models of care that are family-centered, affordable and accessible and that prioritize cultural safety.

  Cannot be inferred:

  Does not show how common discrimination in dental care is among Indigenous Australians. Does not show whether the named enablers improve access or oral health. Does not describe other states or territories.

  Limits:

  Abstract only; the PMC full text was under embargo at retrieval, and doi.org and the publisher host were blocked. Participants came from a dental care study and may differ from people not in contact with services. The abstract gives no interview dates or frequencies.

  Source: JDR Clinical & Translational Research (Aiyar R, Nath S, Hedges J, et al.); abstract via PubMed, Indigenous Australians' Oral Health Care Experiences: Recommendations for Culturally Safe Dental Care. (Abstract, Results and Knowledge Transfer Statement (JDR Clin Trans Res 2026;11(4):678-690)). Where: Australia (South Australia). Population: 136 Indigenous South Australian adults who took part in a dental care intervention with oral examinations at baseline and 12-month follow-up. Published 2025-11-30; retrieved 2026-10-12.

• The sourced examples include measured outcome, guidance, reported experience, service in operation. Each quote was matched to the source text; that is not independent expert review.
• The prompts and fictional case are original. They have not been tested with patients, caregivers or clinicians.
• Whether this workflow helps anyone is an open research question.
• Content is in English. Interface translations are not reviewed for this topic.