How to fix dental deserts: Global lessons from 26 countries

Fraser Macdonald, Dental Tribune International

Tue. 15. July 2025

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LONDON, England: Equitable access to high-quality dental care is one of the major public health challenges the UK has had to grapple with in recent years. Owing to reductions in government spending—which have contributed to personnel shortages and clinic closures—many people across the country are experiencing great difficulty in accessing dental appointments. Because of chronic neglect, the issue has only continued to worsen, and some areas have now become so isolated from dental care that they have been dubbed “dental deserts”. A new systematic review canvassing the global literature on ameliorating access to dental care has sought to extract useful lessons that might be applied in the UK context.

Drawing from 37 studies across 26 countries, the review applies The Lancet’s high-quality health systems framework to categorise interventions aimed at reducing geographic inequities in oral healthcare. Four main categories of interventions emerged: workforce initiatives, outreach programmes, in-reach strategies and auxiliary access efforts. Each contributes uniquely to overcoming access barriers, and they collectively highlight the importance of a multifaceted approach.

Workforce initiatives are among the most widely used and effective. Training mid-level providers such as dental therapists and dental nurses helps extend care delivery, especially in underserved areas, and frees up dentists to handle more complex cases. Additionally, involving non-dental personnel—such as teachers or community health workers—proves effective in rural and Indigenous communities where traditional dental providers are scarce.

Outreach efforts include teledentistry, mobile dental clinics and temporary outreach camps. These services significantly improve access, particularly in rural and remote regions. Teledentistry enhances diagnostic efficiency and patient satisfaction, and mobile and temporary clinics reach thousands of patients, many of whom have never received dental care before.

In-reach strategies typically involve dental schools establishing clinics in underserved areas. These clinics serve dual purposes: they provide care to the community and encourage dental students to practise in rural settings after graduation. Evidence shows that such exposure increases the likelihood of retaining new practitioners in these areas.

Auxiliary access efforts are interventions focused on affordability, community engagement, cost-effectiveness and clinician incentives. Although less studied in isolation, these strategies often underpin the success of the other three categories. Importantly, most interventions span multiple domains of the health system, underscoring the value of integrated solutions.

The review concludes that there is no one-size-fits-all solution. However, sustainable impact is most likely when interventions are community-informed, structurally embedded and supported by policy and funding. These lessons are globally relevant, as many countries—including high-income nations—face growing disparities in dental care access.

By synthesising a wide range of international experiences, the review provides a strong foundation for future policy and practice aimed at eradicating dental deserts through systemic, scalable and context-specific innovations.

The study, titled “Tackling geographic barriers to primary dental care (dental deserts): A systematic review”, was published online on 20 June 2025 in the British Dental Journal, ahead of inclusion in an issue.

Topics:

Public Health Dentistry

Tags:

Community dentists Dental research Dental training NHS dental crisis Outreach effort Recruitment

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