Access to Dental Care
A Global and Local Issue
Oral diseases affect an estimated 3.5 billion people worldwide, making them one of the most common health conditions globally. Despite this significant burden, access to dental care remains uneven both within and between countries (World Health Organization, 2022; GBD 2021 Oral Disorders Collaborators, 2025).
In Australia and internationally, gaps in access are shaped by overlapping structural, economic, and individual factors. These disparities are not simply about availability of services, but also about who can realistically reach and use them.
Key Barriers to Dental Care
1. Geographic Inequalities
Geographic location continues tobe one of the strongest determinants of access to dental care.
People living in rural and remote areas often face a combination of workforce shortages, long travel distances, and limited service availability. These challenges can result in delays care or foregoing treatment altogether.
Research consistently shows that rural populations experience higher rates of untreated oral disease and lower utilisation of preventive services compared to urban populations (Gao et al.,2019; Sidhu et al., 2024). These disparities are closely linked to broader health system distribution issues and highlight the limitations of traditional clinic-based models.
2. Cost and Affordability
Financial barriers remain amajor factor influencing access to dental care.
In many healthcare systems,dental services are not fully covered by public funding, leading to highout-of-pocket costs. This can discourage individuals, particularly those onlower incomes, from seeking preventive care or early treatment.
Evidence indicates that cost-related barriers contribute to delayed care, which often results in more advanced disease and the need for more complex interventions (Murali et al.,2025). This creates a cycle where those most in need of care are also the least likely to access it.
3. Mobility and Health Factors
Physical access is another significant challenge, particularly for older adults and individuals with chronic health conditions or disabilities.
Limitations in mobility, reliance on caregivers, and difficulties with transport can make attending appointments impractical. For individuals in residential aged-care settings orthose with high care needs, accessing traditional dental clinics may not be feasible.
These barriers are associated with reduced utilisation of routine care and a higher likelihood of untreated oral health problems (Oishi et al., 2021).
4. Cognitive and Psychosocial Barriers
Access to dental care is also influenced by psychological, cognitive, and social factors.
Individuals living with dementia, mental health conditions, or dental anxiety may find clinical environments overwhelming or difficult to navigate. Cognitive impairments can affect communication, understanding, and the ability to engage with care.
Research highlights that access is shaped by a combination of health status, psychological factors, and social support, with these elements often interacting to create complex barriers for vulnerable populations (Murali et al., 2025; Rani et al., 2024).
The Impact of Limited Access
When access to dental care is restricted, oral health problems often progress without intervention.
Untreated conditions can lead to pain, infection, and difficulty eating or speaking. Over time, this affects nutrition, general health, and overall quality of life.
There is also a broader impact on health systems. Delayed care increases the likelihood of acute presentations, including hospital visits for preventable dental conditions. This places additional strain on health care services and highlights the importance of early, accessible care.
Poor oral health has been linked to systemic health risks, particularly in older adults and medically vulnerable populations, further reinforcing the need for consistent access to preventive services (Oishi etal., 2021).
Rethinking Models of Care
Addressing access disparities requires more than expanding traditional services. It calls for new approaches to how care is delivered.
Mobile dentistry and community-based care models are increasingly recognised as effective ways to improve accessibility, particularly for underserved populations. By bringing care directly , these models reduce barriers related to geography, transport, andmobility.
Systematic reviews and program evaluations show that mobile dental services can increase utilisation, improve reach, and provide essential preventive and restorative care in populations that are otherwise difficult to engage (Vashishtha et al., 2014; Gupta et al., 2019).
These models also support more flexible, person-centred care by adapting services to the needs of individuals and communities, rather than relying solely on fixed clinical settings.
As healthcare systems continue to evolve, integrating alternative service models will be essential in reducing inequalities and improving oral health outcomes at both local and global levels.
References
GBD 2021 Oral Disorders Collaborators. (2025). Trends in theglobal burden of oral conditions from 1990 to 2021. The Lancet.
Gao, S. S., Yon, M. J. Y., Chen, K. J., Duangthip, D., Lo,E. C. M., & Chu, C. H. (2019). Utilization of a mobile dental vehicle fororal healthcare in rural areas. International Journal of EnvironmentalResearch and Public Health, 16(7), 1234.
Gupta, S., Hakim, M., Patel, D., Stow, L. C., Shin, K.,Timothé, P., & Nalliah, R. P. (2019). Reaching vulnerable populations through portable and mobile dentistry. Dentistry Journal, 7(3), 75.
Murali, A., Muddappa, S. C., Rajan, R. R., Joseph, A., &Ravi, A. B. (2025). Barriers to geriatric oral health: A multifaceted publichealth issue. Cureus, 17(8), e89604.
Oishi, M. M., Childs, C. A., Gluch, J. I., & Marchini,L. (2021). Delivery and financing of oral health care in long-term services andsupports: A scoping review. Journal of the American Dental Association, 152(3),215–223.
Rani, H., Mohd-Dom, T. N., Meei, T. I., Rosli, M. S. A.,Quan, L. Z., Aziz, A. F. A., & Aun, N. S. M. (2024). Investigating thechallenges and opportunities of domiciliary oral care for older adults. Healthcare,12(23), 2469.
Sidhu, H. K., Randhawa, G. S., & Kaur, G. (2024).Evaluating rural dental health disparities and their effects on communitywell-being. International Journal of Dental Sciences and Research, 12(3),41–52.
Vashishtha, V., Kote, S., Basavaraj, P., Singla, A., &Pandita, V. (2014). Reach the unreached: A systematic review on mobile dentalunits. Journal of Clinical and Diagnostic Research, 8(8), ZE05–ZE08.
World Health Organization. (2022). Global oral healthstatus report.
