Oral health status and oral healthcare system in India: a narrative review
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260723Keywords:
National oral health programme, Oral health system, IndiaAbstract
India’s National Oral Health Programme (NOHP) was launched in 2014 to strengthen oral health services, however, a consolidated evaluation of its implementation and progress remains limited. Therefore, we aimed to synthesize evidence on India’s oral disease burden and oral health system progress (NOHP) from 2014 to 2025. A comprehensive search was conducted in PubMed, Embase, Google Scholar, and government websites (August-October 2025). We included all study designs, reports and programme documents (2014-25), excluding non-oral health and non-English/non-full text articles. Data extraction covered major dental conditions, and programme domains were mapped using WHO health-system building blocks. Findings were narratively summarised, NOHP’S funding mapped using QGIS 3.28, and study quality appraised using SANRA checklist. Dental caries prevalence ranged from 19.6% to 94% (mean DMFT/DMFT: 0.4-2.8). Gingivitis affected 46.6% of the population and periodontitis was 51% (≥15 years). Partial edentulism ranged 13.4-100% and the complete edentulism was 5.3-90.5%, with national estimates of 61.9% and 7.2% (≥45 years), respectively. Orofacial clefts occurred at a rate of 0.9 per 1,000 births, with 50-60% of cases being cleft lip and palate. India reported 143,759 new oral cancer cases in 2022 (ASR: 9.9/100,000). Programme improvements included PHC-level dental units, tobacco cessation centres, mobile-dental vans, screening collaborations (NTCP, NP-NCD, RBSK), school dental programmes and dental amalgam phase-down. Despite 3.7 lakh dentists, rural availability remains low (1:25000). Two Centres of Excellence and three National Resource Centres were established, alongside the national oral health policy draft. India has strengthened oral health services (OHS) under NOHP, yet gaps persist in coverage, funding, oral health information management system (OHIMS) and workforce distribution. Stronger primary-care integration, expanding preventive services and unified OHIMS are essential for equitable OHS.
Metrics
References
World Health Organization. Global strategy and action plan on oral health 2023-2030. 2024;1-104. Available at: https://www.who.int/publications/i/ item/9789240090538. Accessed on 03 November 2025.
FDI World Dental Federation. Oral health and quality of life. Available at: https://www. fdiworlddental.org/oral-health-and-quality-life. Accessed on 03 November 2025.
Rawal I, Ghosh S, Hameed SS, Shivashankar R, Ajay VS, Patel SA, et al. Association between poor oral health and diabetes among Indian adult population: Potential for integration with NCDs. BMC Oral Health. 2019;19(1):191. DOI: https://doi.org/10.1186/s12903-019-0884-4
World Health Organization. Oral health. Available at: https://www.who.int/news-room/fact-sheets/ detail/oral-health. Accessed on 03 November 2025.
Dasson BP, Shenoy R, Davda LS, Mala K, Bajaj G, Rao A, et al. A scoping review exploring oral health inequalities in India: a call for action to reform policy, practice and research. Int J Equity Health. 2023;22(1):242. DOI: https://doi.org/10.1186/s12939-023-02056-5
Singh A, Purohit BM. Addressing oral health disparities, inequity in access and workforce issues in a developing country. Int Dent J. 2013;63(5):225-9. DOI: https://doi.org/10.1111/idj.12035
Theriault H, Bridge G. Oral health equity for rural communities: where are we now and where can we go from here?. Br Dent J. 2023;235(2):99-102. DOI: https://doi.org/10.1038/s41415-023-6058-4
Ministry of Health and Family Welfare. Government of India. National Oral Health Division (NOHD). Available at: https://dghs.mohfw. gov.in/national-oral-health-division.php. Accessed on 03 November 2025.
Ministry of Health and Family Welfare. Government of India. Operational Guidelines for National Oral Health Program. 2022. Available at: https://dghs.mohfw.gov.in/national-oral-health-division.php. Accessed on 03 November 2025.
Narang P, Dhoble A, Mathur M, Rana S, Mason S, Ali A. India’s oral health outlook: challenges, economic impact and need for preventative strategies. Front Dent Med. 2025;6:1544899. DOI: https://doi.org/10.3389/fdmed.2025.1544899
WHO. Dentists (per 10 000 population) . Available at:https://www.who.int/data/gho/data/indicators/indicator-details/GHO/dentists-(per-10-000-population). Accessed on 03 November 2025.
Shaw S, Khan J. Risk of dental caries and periodontal disease among older adults and elderly persons with diabetes in India: a population-based cross-sectional study. BMC Oral Health. 2025;25(1):737.
Tamchos R, Rahul M, Mathur VP, Tewari N, Bansal K, Priya H. Prevalence of early childhood caries among preschool children of tribal Leh district of Ladakh: A cross‑sectional study. J Indian Soc Pedod Prev Dent. 2025;43(2):182-8. DOI: https://doi.org/10.4103/jisppd.jisppd_53_25
Chevvuri R, Sharma H, Gupta R, Tiwari A, Singh G, Singh A. Prevalence and determinants of early childhood caries among children enrolled in anganwadi centres in Bhilai of Central India: A cross-sectional study. Indian J Dent Res. 2022;33(3):297-300. DOI: https://doi.org/10.4103/ijdr.ijdr_128_21
Das D, Suresan V, Jnaneswar A, Khurana C, Bhadauria US, Saha D. Oral health status and treatment needs among the Juang tribe-a particularly vulnerable tribal group residing in Northern Odisha, India: A cross-sectional study. Health Soc Care Community. 2019;27(5):e752-9. DOI: https://doi.org/10.1111/hsc.12788
Prabakar J, John J, Srisakthi D. Prevalence of dental caries and treatment needs among school going children of Chandigarh. Indian J Dent Res. 2016;27(5):547-52. DOI: https://doi.org/10.4103/0970-9290.195683
Mohanty S, Behera D, Tripathy S, Jena M, Behera MR, Panda B. Prevalence, risk factors, and parental perspectives of dental caries in children in Odisha: A mixed-method study. Clin Epidemiol Global Health. 2024;29:101748. DOI: https://doi.org/10.1016/j.cegh.2024.101748
Janakiram C, Mehta A, Venkitachalam R. Prevalence of periodontal disease among adults in India: A systematic review and meta-analysis. J Oral Biol Craniofac Res. 2020;10(4):800-6. DOI: https://doi.org/10.1016/j.jobcr.2020.10.016
Kumar S, Tadakamadla J, Zimmer‐Gembeck M, Kroon J, Lalloo R, Johnson NW. The Effect of Parenting Practices on the Severity of Gingival Bleeding in Children. J Periodontol. 2017;88(8):744-51. DOI: https://doi.org/10.1902/jop.2017.160817
Balraj L, Oswal KC, Reddy RBV, Kunjan PD, Chandu VC, Mathur MR. Assessment of Oral Health Status, Care Seeking Behaviours, and Oral Health‑Related Quality of Life among Indian Adults Using the World Dental Federation’s Digital Application. Indian J Dent Res. 2024;35(4):390-4. DOI: https://doi.org/10.4103/ijdr.ijdr_423_24
Ravindranath R, Ramakrishnan J, Mathavaswami V, Ravel V, Madhan B. Prevalence of Edentulism, Associated Factors, Perceived Treatment Needs and Barriers for Dental Care among the Elderly in a Rural Area of Puducherry, India: A Community-based Mixed-method Study. J Clin Diagon Res. 2025;19(2):ZC15-21. DOI: https://doi.org/10.7860/JCDR/2025/74405.20596
Manimaran P, Kumar C, Saisadan D, Abirami M, Kumar N, Mani J. Partial Edentulousness in a Rural Population Based on Kennedy’s Classification: Epidemiological Study. J Pharm Bioallied Sci. 2017;9(1):S34-6. DOI: https://doi.org/10.4103/jpbs.JPBS_87_17
Ghosal S, Sinha A, Kerketta S, Acharya AS, Kanungo S, Pati S. Oral health among adults aged ≥45 years in India: Exploring prevalence, correlates and patterns of oral morbidity from LASI wave-1. Clin Epidemiol Glob Health. 2022;18:101177.
Singh S, Singh D, Utreja A, Jena A, Verma S, Verma RK. Epidemiology of Cleft Lip and Palate among Infants Born in Chandigarh. J Postgrad Med Educ Res. 2022;56(1):13-20. DOI: https://doi.org/10.5005/jp-journals-10028-1550
Diwana V, Gupta G, Chauhan R, Mahajan K, Mahajan A, Gupta R, et al. Clinical and epidemiological profile of patients with cleft lip and palate anomaly: 10-year experience from a tertiary care center in the sub-himalayan state of Himachal Pradesh in Northern India. J Nat Sci Biol Med. 2019;10(1):82-6. DOI: https://doi.org/10.4103/jnsbm.JNSBM_220_17
Prabakaran S, Kasthuri TK, Reddy MR. Profile of Cleft Lip and Cleft Palate at a Public Hospital in Southern India. Indian Pediatr. 2019;56(9):753-5. DOI: https://doi.org/10.1007/s13312-019-1643-y
Vijaya V, Pasha, Fathima A, Gopichand S. Cleft lip/ palate and its relationship with socio-demographic factors in 0-15 years old children attending tertiary care centre, Nandyal, Andhra Pradesh, India. Int J Community Med Public Health. 2017;4(2):477-80. DOI: https://doi.org/10.18203/2394-6040.ijcmph20170276
Sharma S, Satyanarayana L, Asthana S, Shivalingesh KK, Goutham BS, Ramachandra S. Oral cancer statistics in India on the basis of first report of 29 population-based cancer registries. J Oral Maxillofac Pathol. 2018;22(1):18. DOI: https://doi.org/10.4103/jomfp.JOMFP_113_17
Babu A, Mathew RT, Shetty R. Pattern of oral cancer in india: An analysis of hospital based cancer registry data. J Indian Acad Oral Med Radiol. 2023;35(4):497-500. DOI: https://doi.org/10.4103/jiaomr.jiaomr_145_23
World Cancer Research Fund. Mouth and oral cancer statistics. Available at: https://www.wcrf.org/preventing-cancer/cancer-statistics/mouth-and-oral-cancer-statistics/. Accessed on 03 November 2025.
Roy PK, Biswas S, Dhar M. Assessment and Projections of the Burden of Lip and Oral Cancer among Indian Men. Asian Pac J Cancer Prev. 2025;26(8):2803-10. DOI: https://doi.org/10.31557/APJCP.2025.26.8.2803
Kumbhalwar A, Shetiya SH, Kakodkar P, Mehta V, Mathur A, Porwal P. Prevalence of precancerous lesions and conditions in India: A systematic review and meta-analysis. World J Methodol. 2022;12(4):293. DOI: https://doi.org/10.5662/wjm.v12.i4.293
Dental Council of India. Available at: https://dciindia.gov.in/. Accessed on 03 November 2025.
Padminee K, Anusha R, Lakshmi K, Madan Kumar P. Geographic disproportions in dental workforce distribution and its impact on oral disease burden: An Indian perspective. SRM J Res Dent Sci. 2020;11(2):76. DOI: https://doi.org/10.4103/srmjrds.srmjrds_79_19
Mendonca M. Rural India’s Dental Crisis: Millions Without Access to Basic Oral Care. Dental News. 2025. Available at: https://dentistchannel.online/rural-india-s-dental-crisis-millions-without-access-to-basic-oral-care/article?. Accessed on 03 November 2025.
National Health Authority. Ministry of Health and Family Welfare. Government of India. Ayushman Bharat Health Account - ABHA Number. 2025. Available at: https://abha.abdm.gov.in/abha/v3/. Accessed on 03 November 2025.
Sathishkumar K, Sankarapillai J, Santhappan S, Mathew A, Nair RA, Gangane N, et al. Geographic Disparities in Oral Cancer Survival From 10 Population-Based Cancer Registries in India. JAMA Netw Open. 2025;8(4):e253910. DOI: https://doi.org/10.1001/jamanetworkopen.2025.3910
National Centre For Diseases Informatics and Reserach. Annual Highlights. 2022. Available at: https://www.ncdirindia.org/Reports.aspx?. Accessed on 03 November 2025.
Kanungo S, Ghosal S, Kerketta S, Sinha A, Mercer SW, Lee JT, et al. Association of Oral Health with Multimorbidity among Older Adults: Findings from the Longitudinal Ageing Study in India, Wave-1, 2017-2019. Int J Environ Res Public Health. 2021;18(23):12553. DOI: https://doi.org/10.3390/ijerph182312853
State National Health Mission Program Implementation Plans and Record Of Proceedings. National Health Mission. Available at: https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1377&lid=744. Accessed on 03 November 2025.
Press Information Bureau Government of India. National Health Account (NHA) Estimates 2020-21 and 2021-22. Available at: https://www.pib.gov.in/ PressNoteDetails.aspx?NoteId=153237&ModuleId=3. Accessed on 22 November 2025.
Syamkumar V, Bhat PK, Nair RU, Suresh K, Kumbla S, Nair A. Assessment of Oral Health Care-Related Expenditure among People of Kerala: A Cross-Sectional Study. J Pharm Bioallied Sci. 2022;14(1):S479-82. DOI: https://doi.org/10.4103/jpbs.jpbs_716_21
Nobelika AA, Simon A. An observational study to find the patterns of out-of-pocket expenditure for oral healthcare among sanitary workers in Coimbatore, India. J Indian Assoc Public Health Dent. 2020;18(2):143. DOI: https://doi.org/10.4103/jiaphd.jiaphd_78_19
Verma S, Sharma H, Chevvuri R. Oral healthcare-related expenditure among people residing in Durg, Chhattisgarh: A household survey. J Indian Assoc Public Health Dent. 2018;16(2):160. DOI: https://doi.org/10.4103/jiaphd.jiaphd_17_18
National Oral Health Programme. 2025. Available at:https://www.pib.gov.in/newsite/PrintRelease.aspx?relid=160654. Accessed on 03 November 2025.
Rashtriya Bal Swasthya Karyakram (RBSK). 2025. Available at: https://rbsk.mohfw.gov.in/RBSK/. Accessed on 03 November 2025.
Bala R, Sargaiyan V, Rathi SA, Mankar SS, Jaiswal AK, Mankar SA. Mobile dental clinic for oral health services to underserved rural Indian communities. Bioinformation. 2023;19(13):1383. DOI: https://doi.org/10.6026/973206300191383
Neeraj DA, Jasbir DS, Somanna PK, Harish DB, Arun PP, Samuel MC. Impact of perinatal oral health care education programme on the knowledge, attitude and practice behavior amongst gynaecologists of Vadodara city. J Indian Soc Pedod Prev Dent. 2015;33(2):122-7. DOI: https://doi.org/10.4103/0970-4388.155124
Barjatya K, Nayak U, Vatsal A. Association between early childhood caries and feeding practices among 3-5-year-old children of Indore, India. J Indian Society Pedodont Preventive Dent. 2020;38(2):98–103. DOI: https://doi.org/10.4103/JISPPD.JISPPD_60_20
Nagarajappa R, Naik D, Satyarup D, Dalai RP. Risk factors and patterns related to dental caries evaluated with caries assessment spectrum and treatment (cast) among schoolchildren of Bhubaneswar, India. Roczniki Panstwowego Zakladu Higieny. 2020;71(1):113–22. DOI: https://doi.org/10.32394/rpzh.2020.0103
Sukumar MBA, Peter RM, Joseph A. Tooth morbidity and its impact on oral related quality of life in elderly tribal population-The Irula experience. BMC Oral Health. 2025;25(1). DOI: https://doi.org/10.1186/s12903-025-05628-9
Jeseem MT, Veetil SMT, Vadakkepurayil K, Manningal MR. Oral health status and treatment needs among 5-15-year-old children of tribal population in Noolpuzha Panchayath of Wayanad: A cross-sectional study. J Indian Society Pedodont Prevent Dent. 2025;43(1):50–6. DOI: https://doi.org/10.4103/jisppd.jisppd_37_25
Sharma K, Gupta K, Gaur A, Sharma A, Pathania V, Thakur V. A cross-sectional study to assess the prevalence of early childhood caries and associated risk factors in preschool children in district Mandi, Himachal Pradesh. J Indian Society Pedodont Prevent Dent. 2019;37(4):339–44. DOI: https://doi.org/10.4103/JISPPD.JISPPD_95_18
Marya C, Kataria S, Nagpal R, Oberoi SS, Dhingra C, Arora D. A Cross-sectional Study for Assessment of Untreated Dental Caries and Its Consequences among Slum-dwelling Children. Int J Clin Pediat Dent. 2017;10(1):29–33. DOI: https://doi.org/10.5005/jp-journals-10005-1402
Chugh VK, Sahu KK, Chugh A. Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India. Int J Clinical Pediatr Dent. 2018;11(3):238–43. DOI: https://doi.org/10.5005/jp-journals-10005-1518
Rangnekar N, Chalakkal P. The prevalence of early childhood caries and treatment needs among children attending Anganwadi centers in Goa state: A cross‑sectional survey. J Indian Society Pedodont Prevent Dent. 2023;41(4):288–96. DOI: https://doi.org/10.4103/jisppd.jisppd_501_23
Shaw S, Khan J. Risk of dental caries and periodontal disease among older adults and elderly persons with diabetes in India: a population-based cross-sectional study. BMC Oral Health. 2025;25(1). DOI: https://doi.org/10.1186/s12903-025-06067-2
Dain CP, Ganapathi S, Ranjithkumar A, Geevar Z, Harikrishnan S, Ammu JV. Prevalence and Risk Factors of Periodontal Disease among Rural and Urban Residents of a South Indian City: A Cross-Sectional Study. J Int Society Prevent Community Dent. 2023;13(6):458–68. DOI: https://doi.org/10.4103/jispcd.JISPCD_77_23
Shenoy RP, Salam TAA, Agrawal R SK. View of Oral hygiene practices and their influence on the oral health of adolescents. Int J Community Med Public Health. 2020;7(7):2556. DOI: https://doi.org/10.18203/2394-6040.ijcmph20202976
Ghosal S, Sinha A, Kerketta S, Acharya AS, Kanungo S, Pati S. Oral health among adults aged ≥45 years in India: Exploring prevalence, correlates and patterns of oral morbidity from LASI wave-1. Clin Epidemiol Global Health. 2022;18:101177. DOI: https://doi.org/10.1016/j.cegh.2022.101177
Athar S, Arora S, Kalsi R, Saurav K, Arora V, Baro K. Prevalence of periodontitis and its association with smokeless tobacco (SLT) Use amongst the adult population of Greater Noida, India - A cross-sectional study. Indian J Dent Res. 2022;33(4):397–401. DOI: https://doi.org/10.4103/ijdr.ijdr_351_22
Sujatha S, Jalihal UM, Sharma S. Association between periodontal disease and oral and gastric Helicobacter pylori infection. Indian J Gastroenterol. 2015;34(4):343–4. DOI: https://doi.org/10.1007/s12664-015-0569-0
Janakiram C, Antony B, Joseph J, Ramanarayanan V. Prevalence of Dental Caries in India among the WHO Index Age Groups: A Meta-Analysis. J Clin Diagnost Res. 2018;12(8):ZE08-ZE13. DOI: https://doi.org/10.7860/JCDR/2018/32669.11956
Sharva V, Reddy V, Bhambal A, Agrawal R. Prevalence of Gingivitis among Children of Urban and Rural Areas of Bhopal District, India. J Clin Diagnost Res: JCDR. 2014;8(11):ZC52–4. DOI: https://doi.org/10.7860/JCDR/2014/10092.5135
Selvaraj S, Naing NN, Wan-Arfah N, Abreu MHNG de. Demographic and Habitual Factors of Periodontal Disease among South Indian Adults. Int J Environ Res Public Health. 2021;18(15). DOI: https://doi.org/10.3390/ijerph18157910
Sharma N, Saxena V, Naithani M. Prevalence of Gingivitis and Associated Factors in 619-Year-Old Children in Rudraprayag District, Uttarakhand. J Indian Assoc Public Health Dent. 2021;19(4):277–82. DOI: https://doi.org/10.4103/jiaphd.jiaphd_80_21
Ghosh S, R B, Yadav P, Bagchi S. Prevalence of periodontal diseases among patients attending at Dr. R. Ahmed dental college & hospital, Kolkata, W.B. Int J Oral Health Dent. 2025;8(1):59–63. DOI: https://doi.org/10.18231/j.ijohd.2022.012
Gopalankutty N, Vadakkekuttical RJ, Remadevi S, Pillai AS. Prevalence of periodontitis and its correlates among tribal population of Attapady block, Palakkad District, Kerala. J Indian Society Periodontol. 2020;24(3):264. DOI: https://doi.org/10.4103/jisp.jisp_248_19
Tomar D, Menon I, Singh A, Tyagi U, Passi D, Goyal J. Comparative study of risk indicators associated with tooth loss among adult population in urban and rural areas of Muradnagar, Ghaziabad, Uttar Pradesh, India. J Family Med Primary Care. 2019;8(2):528. DOI: https://doi.org/10.4103/jfmpc.jfmpc_409_18
Vaddi JK, Jesija JS, Prasad JD, Kattula D, Paul GJS, Prasad JH. Assessment of Oral Health Status and Factors Associated with Oral Health-related Quality of Life among Geriatric Population in Rural South India – A Community-based Cross-sectional Study. J Indian Acad Geriatr. 2024;20(1):3–11. DOI: https://doi.org/10.4103/jiag.jiag_7_24
Prasad S, Garg S. Prevalence of Partial Edentulism and Awareness to Restore the Same among the Patients Visiting a Tertiary Dental Care Centre in Ambala, Haryana, India: A Cross-sectional Study. J Clin Diagnost Res. 2025;19(04):ZC13–7. DOI: https://doi.org/10.7860/JCDR/2025/74059.20828
Ashraf J, Jain AR, Ariga P, Nallaswamy D. Prevalence of Partial Edentulousness and Treatment needs in Rural Population of South India. World J Dent. 2016;8(3):213–7. DOI: https://doi.org/10.5005/jp-journals-10015-1440
Sen S, Balwani T, Sahu A, Parate N, Gehani A, Deolia S. Tooth loss and associated risk factors among rural population of Wardha District: A cross-sectional study. J Indian Assoc Public Health Dent. 2018;16(1):11. DOI: https://doi.org/10.4103/jiaphd.jiaphd_106_17
Barman J, Kalita C, Baruah R, Choudhury K. Tooth Loss and Its Risk Factors Among the Young Adults in the Kamrup (Metro) District of Assam. J Indian Assoc Public Health Dent. 2022;20(2):159–67. DOI: https://doi.org/10.4103/jiaphd.jiaphd_136_21
Shivlani VI, Niranjane PP, Diagavane PS, Madhu PP. Demographic Profile of Patients with Cleft Lip and Palate Anomaly: 15-year Experience from a Tertiary Care Hospital and Teaching Institute in Wardha District of Maharashtra, India. Int J Clinical Pediatr Dent. 2023;16(Suppl 3):S278–82. DOI: https://doi.org/10.5005/jp-journals-10005-2675
Datta S, Singh VK. Epidemiological pattern of cleft lip and palate under Rashtriya Bal Swasthya Karyakram project in the state of Bihar: A cross-sectional hospital-based study. J Family Med Primary Care. 2025;14(7):2842–6. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1643_24
Shaikh MF, Dodia H. Study of Cleft Lip and Cleft Palate in Tribal Areas of Gujarat. Int J Sci Res. 2020;9(11).
Meenal M, Manipal S, Duraisamy P, Adusumilli P, Ahmed MAA. Out-of-Pocket Costs in the Private and the Public Sector in Dent: A Comparative Study. Res Rev J Dent. 2019;4(1):14–9.