A silent epidemic: India's overlooked oral health crisis (2025)

ByDr Indu Bhushan

As the country plans its trajectory to become Viksit Bharat by 2047, a critical but neglected aspect of public health threatens to hold us back: Oral health. The statistics paint a stark picture. Nearly nine out of 10 Indians suffer from some kind of oral ailment, with a particularly concerning prevalence of gum diseases and cavities. This silent crisis not only impacts individual well-being but also poses a significant challenge to the nation's productivity and economic growth.

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The economic impact is equally concerning. India faces annual productivity losses of over $7.2 billion, which equals to roughly ₹60,500 crore, due to the top five oral diseases. This figure fails to capture the human cost of chronic pain, diminished quality of life, and lost educational opportunities for our children. The burden falls disproportionately on our rural population, where access to dental care remains severely limited.

he challenges we face in oral care are systemic and multifaceted. Despite having one of the largest dental workforces globally, with over 270,000 dentists, the distribution remains heavily skewed toward urban areas. This urban-rural divide is further exacerbated by inadequate public health infrastructure and prohibitive treatment costs. On top of it, our southern states have nearly 43% of dental institutes, creating another layer of disparity.

The regulatory framework presents another critical bottleneck. Yes, India's National Health Policy 2017 acknowledges oral health. It recommends that oral health screening be a focus, along with screening for other cancers and Chronic Obstructive Pulmonary Disease (COPD). However, the policy does so only peripherally, lacking the comprehensive approach needed to address this public health challenge.

The absence of dental coverage in most health insurance schemes, which is clubbed as a cosmetic procedure, further compounds the problem, pushing millions into financial distress when seeking treatment.

Based on my experience of implementing large-scale health care initiatives in India and other countries, I believe a multi-pronged approach is needed to address India's oral health crisis. First and foremost, we should integrate oral health into primary care. Our primary health care system must include basic dental services, including dental checkups as part of the full body check.

This integration should be supported by adequate funding and infrastructure, particularly in rural areas where the need is most acute, but the long-term benefits far outweigh these initial investments. We also need innovative policies to incentivise dental professionals to practice in rural areas. This could include mandatory rural service periods, financial incentives, and support for setting up practices in underserved regions.

The data shows that almost one-fourth of those suffering from oral problems take no action – a trend we must reverse through awareness and accessibility of preventive services. We need to develop a prevention-first approach. So, public health campaigns should focus on preventive care and oral hygiene education. The Rashtriya Bal Swasthya Karyakram (RBSK) also offers an excellent platform to incorporate comprehensive oral health screening and education. By reaching children early, we can instill good oral hygiene habits and identify problems before they become severe. When we reach children, we effectively reach their families too.

However, detection without treatment access serves little purpose. This brings me to a critical reform needed in our health care financing: the inclusion of essential dental procedures in our health insurance schemes, particularly in Ayushman Bharat Pradhan Mantri Jan Arogya Yojna. Currently, most Indians pay for dental care out of pocket, creating a significant financial barrier to treatment. By including dental coverage in our national health insurance programmes, we can make quality dental care accessible to millions of Indians who currently go without it.

Another critical reform would be stronger regulations, especially for addressing the cost barrier. Essential dental products, treatments, and services should come under price regulation to ensure affordability. However, this must be balanced with quality standards to prevent substandard care and products from entering the market. And, lastly, we need to promote digital innovation in the field. We should leverage tele-dentistry and mobile dental units to reach remote areas and provide basic screening and emergency care services.

The transformation of India's oral care system requires a collaborative effort between government agencies, health care providers, educational institutions, and the private sector. We need to move beyond viewing Oral Health as a luxury and recognise it as a fundamental right that impacts overall health and economic productivity.

The prescription for India's dental health is clear: we need a comprehensive national oral health policy that addresses these systemic challenges while ensuring equitable access to quality care. The investment required may seem substantial, but the cost of inaction – both in human and economic terms – is far greater.

As we work towards our vision of a Viksit Bharat, let us not forget that every smile matters, and every citizen deserves access to quality oral care. The time for action is now.

This article is authored by Dr Indu Bhushan, former CEO, Ayushman Bharat, New Delhi.