Oral health challenges and opportunities in rural populations: A comprehensive public health perspective

Oral diseases constitute a major public health burden globally and disproportionately affect rural populations due to socioeconomic deprivation, limited access to care, and inadequate integration of oral health within primary healthcare systems. Despite strong evidence linking oral health with systemic diseases and overall well-being, rural oral health remains marginalized in health policy and service delivery frameworks, particularly in low- and middle-income countries such as India. This review aims to comprehensively synthesize existing evidence on the burden, determinants, consequences, and health system challenges related to oral health in rural populations, while identifying research gaps and proposing evidence-based, policy-relevant strategies to reduce rural–urban oral health disparities. A narrative review was conducted using PubMed, Scopus, Web of Science, Google Scholar, and official databases of the World Health Organization and the Ministry of Health and Family Welfare, Government of India. Peer-reviewed articles, national surveys, and policy documents published between 2000 and 2024 were included. Study selection followed PRISMA guidelines, and findings were thematically synthesized. The literature consistently demonstrates a higher prevalence of untreated dental caries, periodontal disease, tooth loss, and oral cancer among rural populations compared to urban counterparts. Key determinants include poverty, low health literacy, workforce maldistribution, infrastructural deficits, cultural practices, and inadequate policy prioritization. Preventive services are limited, and oral healthcare utilization remains largely symptom driven. Rural oral health inequities reflect broader systemic failures in healthcare delivery. Addressing these challenges requires integration of oral health into primary healthcare, redistribution of the dental workforce, community-based prevention strategies, and sustained policy commitment to achieve universal health coverage and improved population health outcomes.