Social Determinants of Oral Health and Access to Dental Care in Southern India: A Narrative Review

Abstract

Background: This narrative review examines social determinants of oral health and dental-care access in Southern India to identify priorities for equitable public dental services.
Methods: English-language literature published from January 2000 to 4 October 2026 was identified through PubMed/MEDLINE, Google Scholar, World Health Organization, and Government of India sources. Evidence was synthesized narratively, informed by the Scale for the Assessment of Narrative Review Articles.
Results: Evidence was geographically uneven. National estimates for 2019 indicated untreated permanent-tooth caries in 28.8% of people aged ≥5 years and severe periodontal disease in 21.8% of those aged ≥15 years. In a Mysore municipal-employee sample, caries prevalence was 43.3% in the upper and 78.6% in the lower socioeconomic category. A national meta-analysis estimated adult dental-service utilization at 23.96%, decreasing to 17.65% after trim-and-fill adjustment for publication bias. The South-zone estimate was 30.02% (95% confidence interval: 19.14–40.90); heterogeneity was very high and geographic-zone differences were nonsignificant. In Prakasam, 13.9% used community health centre dental services, while 91.1% were unaware that care was free.
Conclusion: State and district programmes should prioritize functional dental teams, primary-care referral pathways, public communication of free services and financial protection for disadvantaged groups. Implementation should track unmet need, service utilization and out-of-pocket expenditure across socioeconomic groups; locally evaluated approaches are needed before wider adoption.