In the global architecture of refugee care, oral health is almost always an afterthought. When dental care is offered, it’s typically limited to emergency tooth extractions—relief for pain that can no longer be endured. Studies show that displaced populations suffer from high rates of untreated cavities, gum disease, and tooth loss, often due to limited access to preventive and restorative services.
A 2021 review in BMC Oral Health confirmed that refugees’ oral health needs are consistently under-addressed. Millions suffer from preventable, treatable oral diseases. Their pain is rarely prioritized; their dignity is often overlooked.
This is not just a public health gap—it’s a human rights failure.
Why oral health is a human rights issue
As a dentist and public health researcher, I’ve seen this neglect firsthand—from refugee camps to urban shelters. The pattern is consistent: oral health is excluded from routine care packages, rarely prioritized in funding proposals, and almost never integrated into long-term refugee health strategies. Dental care is often not classified as “life-saving” by global actors such as the UNHCR and is therefore omitted from minimum emergency health packages, even though the Sphere standards, which define humanitarian norms and minimum standards in disaster response, highlight comprehensive healthcare as essential.
This situation creates a hierarchy of suffering and signals that oral pain and dignity are less worthy of urgent care. It also clashes with frameworks like the World Health Organization’s (WHO) 2021 Resolution on Oral Health and the Universal Declaration of Human Rights (UDHR), which affirm the indivisibility of physical, mental, and oral well-being.
Oral health is not cosmetic. It is central to eating, speaking, sleeping, working, and participating in society. Children with untreated tooth decay struggle in school. Older adults with missing teeth face nutritional and social challenges. Women and girls with visible oral disease may withdraw from community life due to stigma. These individual effects deepen structural inequities and reinforce marginalization.
Neglecting oral health violates the principle of non-discrimination enshrined in human rights law. The UDHR affirms the right to an adequate standard of health, which includes dental care. The WHO recognizes oral health as part of universal health coverage, yet most refugees live for years without access to even basic dental services. A 2021 IOM and WHO review noted the near-total absence of oral health services in essential care packages for displaced populations, with field studies in Jordan, Bangladesh, and Uganda showing multi-year delays or a complete lack of care.
Gaps in humanitarian health policy
This exclusion is rarely intentional, but rather deeply systemic. Health interventions in humanitarian settings prioritize immediate survival, neglecting chronic issues like oral disease. Yet emergencies often evolve into long-term crises. In such protracted contexts, the short-term model fails.
Despite the need, dental care remains categorized as “non-essential.” The Sphere Handbook—a global standard for humanitarian action—excludes dental care from its minimum standards except in cases of trauma or acute infection. The Inter-Agency Field Manual on Reproductive Health makes no mention of oral health. These omissions reflect resource constraints, not clinical priorities.
These omissions overlook the mounting evidence linking poor oral health to systemic diseases: periodontitis worsens diabetes and cardiovascular conditions, and it is linked to adverse pregnancy outcomes. Failing to acknowledge these connections further undermines health equity.
Though my research currently focuses on HIV and tuberculosis in Tajikistan, the pattern is clear: children suffer from untreated decay, elders live with gum disease and tooth loss, and those with chronic illnesses are denied critical oral care. The psychological burden—shame, withdrawal, a reluctance to speak or smile—is profound.
A preventable and neglected burden
Many of these challenges are preventable. Refugees often come from regions with limited access to dental hygiene education or fluoridated water. Displacement compounds these vulnerabilities, yet oral health is rarely included in needs assessments or health education materials in shelters or camps. This creates a cycle of pain, silence, and invisibility.
We must reframe oral health as essential. That starts with recognizing the structural inequities preventing access to dental care—and then acting. Host governments, NGOs, and global health actors must include dental services in refugee health plans, from screenings to basic restorative care.
Critics may argue that budgets are limited. But neglecting oral health leads to more expensive complications: emergency interventions, poor nutrition, and worsening chronic diseases. Solutions like mobile dental clinics, task-sharing with community health workers, and culturally tailored hygiene education are feasible and cost-effective.
Funding priorities must also evolve. Dental care is frequently excluded from humanitarian budgets or relegated to the margins. But oral pain, impaired nutrition, and reduced social functioning are public health issues—not luxuries. Untreated dental cavities affect 2.5 billion people globally, and nearly 1 billion live with severe periodontal disease. Among refugees, oral disease rates exceed 70%. These conditions often remain untreated due to a lack of access.
International donors must allocate dedicated funds for oral health—just as they do for maternal care, vaccinations, or mental health—because doing so improves outcomes and reduces long-term costs.
Listening to refugees: Dignity requires more than extractions
Above all, we must listen to refugees. Displaced communities know their needs. They understand what it means to live with unseen pain. Involving them in the design of oral health services—from education materials to clinic hours—ensures care is accepted and sustained. Studies show that when refugees are included in participatory research, the resulting interventions are more trusted, better adapted to local beliefs and practices, and higher in uptake and retention
This transformation can begin during the initial needs assessment phase, using community-based research, focus groups, or health liaisons. Programs should adopt feedback mechanisms so services evolve in response to community needs. With modest investment, these participatory models can be integrated into health delivery within 6–12 months.
Oral health must never be seen as a luxury. It is a mirror of systemic justice—a reflection of who we value and whose pain we ignore. Refugees deserve more than emergency extractions; they deserve the dignity of eating, speaking, and smiling without pain.
Change is not only possible, it is urgently needed. With proven interventions and clear evidence of oral health’s impact on well-being, the continued neglect is indefensible. Integrating oral health into refugee policy is not charity—it’s equity.