Oral care needs policy teeth

Every year, World Oral Health Day, observed on March 20, is a reminder of the role oral health plays in overall well-being. This year’s theme, ‘ ‘A happy mouth is a happy mind’ underscores a crucial yet often overlooked connection.

Oral health is not just about teeth and gums; it is deeply linked to mental health, quality of life, and systemic health. In India, oral diseases are among the most widespread health issues, yet oral healthcare remains under-prioritised in public health policy.

If the National Oral Health Programme’s goals are to be met, policy action must go beyond awareness and move towards integrating oral health into primary healthcare services.

Oral diseases, such as tooth decay, cavities, gum disease, and crooked teeth, affect nearly 85% of Indians at some point in their lives. Poor oral health has been linked to mental health concerns.

Tooth loss, bad breath, and visible dental issues can lead to low self-esteem, anxiety and depression, often resulting in social withdrawal. Oral health also affects appearance and, in turn, social performance.

Research shows strong connections between oral diseases and diabetes, cardiovascular diseases, adverse pregnancy outcomes and respiratory infections. Untreated oral diseases lead to lost workdays and school absenteeism, further deepening socio-economic disparities.

The burden falls disproportionately on marginalised populations, making oral health an issue of social justice. Despite these far-reaching consequences, oral health services are largely absent from India’s public health discourse.

The draft National Oral Health Policy, released in 2021, is yet to be finalised. One key policy-level reform is reducing the high out-of-pocket expenditure incurred for dental treatments.

Although the Ayushman Bharat scheme aims to address this issue, the coverage is limited. Another area is addressing the absence of delivery of essential oral health care at the primary health centre level.

The Ayushman Arogya Mandir programme addresses only oral cancer screening at the sub-centre level, but other oral diseases are neglected. 

I met a 62-year-old male farmer from Mangala village in the Chamarajnagar district in Southern Karnataka who had lost most of his teeth due to untreated infections.

The Karnataka state’s Danta Bhagya Yojana promised him free dentures, but the indirect expenses, multiple visits to the district hospital, and taking days off from work left him struggling. Such stories are common, highlighting the need for better policy formulation, execution, accountability, and monitoring. 

Additionally, the recently launched Karnataka government’s Gruha Arogya Scheme is set to introduce oral cancer screening as part of its broader preventive healthcare efforts.

Given India’s high burden of oral cancer caused by a variety of factors, such as tobacco use and betel quid consumption, this initiative has the potential to save lives through early detection and timely intervention. However, successful implementation will require adequate training of health workers and seamless referral pathways for patients needing specialised care.

To achieve the National Oral Health Programme’s vision of universal oral healthcare, all stakeholders must work collaboratively with the government to implement the following:

Strengthening primary healthcare integration: All oral diseases must be part of India’s Ayushman Bharat initiative, ensuring timely reimbursement to avoid future glitches.

Expanding state-level programmes: Successful programmes like Danta Bhagya Yojana should be strengthened and adopted across other states. 
Real-time programme evaluation: There is a need to move beyond static policies and implement dynamic, data-driven evaluation frameworks that allow continuous improvements in oral health initiatives.

Oral health in national health policies: The 2021 draft National Oral Health Policy is a step in the right direction, but it needs stronger implementation mechanisms. 

Oral health is not a privilege; it is a fundamental right that affects our dignity, confidence, and ability to lead fulfilling lives.

By integrating oral health into national and state health agendas, strengthening public-private partnerships for the public good, and investing in preventive care, we can create a future where a happy mouth truly means a happy mind.

A strong commitment from all stakeholders, including government bodies, research institutions, and civil society, to work towards collaborative leadership will ensure that oral health becomes a national priority. This can take India towards the goal of ‘Health for All’, where everyone, regardless of income, geography, or background, has access to essential oral healthcare.

The writer is a community dentist and works at the Institute of Public Health, Bengaluru.

(Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.)