"India's Hidden Dental Crisis: How the National Oral Health Programme is Fighting Back Against 90% Periodontal Disease Prevalence in 2026"

By Dr. Mayank Chandrakar, Dental Surgeon (MDS, Public Health Dentistry) and Applied Epidemiologist IntroductionAs of January 2026, India's oral health landscape remains one of the most concerning public health challenges. With dental caries affecting over 50-65% of the population across age groups and periodontal (gum) diseases impacting a staggering 80-90% of adults, millions suffer silently from pain, infections, and links to serious systemic conditions like diabetes, heart disease, and preterm births. Rural areas bear the heaviest burden, where access to qualified dentists is severely limited, and preventive care is often nonexistent.The National Oral Health Programme (NOHP), launched by the Ministry of Health & Family Welfare under the National Health Mission (NHM) in 2014-15, stands as India's dedicated national effort to reverse this trend. By integrating oral health into existing public healthcare infrastructure, NOHP aims to deliver affordable, preventive, and curative services to every citizen — especially the underserved rural and low-income populations. National Oral Health Programme - Overview Video

In this extremely detailed, expanded 5000+ word guide (updated with the latest 2024-26 operational insights and 2025 statistics), we break down every aspect of NOHP: from shocking statistics to precise objectives, components, implementation mechanics, state-level progress, persistent challenges, and the promising path forward.1. The Alarming Reality: India's Oral Health Crisis in 2025-2026 – Detailed Statistics and ImpactsOral diseases rank among the most prevalent non-communicable conditions worldwide, yet in India, they receive minimal policy priority compared to other health issues.Recent data (including studies from 2024-2025 and WHO-aligned reports) reveal:

• Dental Caries (Tooth Decay): Prevalence remains high at 51.9-63.1% in key age groups (e.g., 51.9% at 5 years, 53.8% at 12 years, 63.1% at 15 years per older national surveys, with similar trends persisting). Early childhood caries affects 46.9% in urban and 53.6% in rural 5-year-olds. Untreated caries leads to pain, infection, and tooth loss, with treatment needs (fillings, extractions) increasing with age.
• Periodontal (Gum) Diseases: Extremely widespread, with signs in 80-90% of adults. Using the Community Periodontal Index (CPI), periodontal issues affect 50% of 12-year-olds, 75% of 35-44-year-olds, and 86% of those 60+. Gingival bleeding, calculus, and pockets dominate, often linked to poor hygiene and tobacco use.
• Oral Cancer and Tobacco-Related Disorders: India has one of the highest global burdens of oral potentially malignant disorders and cancers, driven by tobacco (smokeless forms like gutka/paan). Tobacco use exacerbates periodontal disease and caries.
• Other Conditions: Dental fluorosis affects ~9% of 12-year-olds; root caries in 3.9-5.4% of adults/elderly; malocclusion and oro-mucosal lesions add to the burden.
• Rural-Urban and Socioeconomic Divide: 72% of India's population lives rurally, but dentist ratios can drop to 1:200,000 in villages. Urban areas show higher caries in some studies due to sugary diets, while rural regions suffer worse periodontal outcomes from poor hygiene and tobacco.
• Systemic Links and Economic Toll: Poor oral health worsens diabetes (increasing risk by 10-18%), cardiovascular disease, and pregnancy complications. Untreated cases cause lost workdays, high out-of-pocket expenses (OOPE), and productivity losses — far exceeding preventive costs. Globally, oral diseases contribute massive DALYs, with India's share disproportionately high due to low awareness and access.

These figures underscore why NOHP is not optional — it's essential for equitable health.Here are some representative visuals of common oral health problems in India to illustrate the severity:(Images show advanced dental caries, severe periodontal disease, and tobacco-related oral lesions — conditions NOHP targets through early screening and prevention.)2. History and Evolution of the National Oral Health Programme – A Detailed Timeline

The National Oral Health Programme (NOHP) represents India's most comprehensive national effort to address the country's massive burden of oral diseases. While oral health has long been recognized as integral to overall well-being, structured government intervention evolved gradually over decades — from early policy drafts and pilot projects to a full-fledged national program integrated with broader health initiatives.This detailed timeline traces the key milestones, drawing from official government sources, surveys, and policy developments. It highlights how fragmented early efforts transformed into a coordinated, nationwide strategy under the Ministry of Health & Family Welfare (MoHFW) and the National Health Mission (NHM).1980s: Foundations of National Oral Health PolicyThe journey began in the 1980s when oral health gained recognition as a public health priority amid rising awareness of dental caries, periodontal diseases, and their links to systemic conditions.

• 1984: National workshops were organized in Bombay (now Mumbai) to discuss oral health targets for India. These gatherings brought together experts to outline goals for prevention, education, and service delivery.
• 1986: The Indian Dental Association (IDA) drafted India's first National Oral Health Policy. This landmark document emphasized preventive and promotive services, workforce development, and integration into general healthcare. It laid the groundwork for future programs by highlighting the need for village-level interventions and research.

These early steps were influenced by global trends, including the World Health Organization (WHO)'s emphasis on oral health as part of "Health for All."1990s: Policy Refinement and Pilot InitiativesThe 1990s saw further refinement and initial implementation attempts.

• 1991 and 1994-95: Additional national workshops (in Delhi and Mysore) built on the 1986 policy. The Dental Council of India (DCI) contributed to developing a more comprehensive national oral health policy framework.
• 1995: The Central Council of Health and Family Welfare accepted the IDA-drafted policy in principle as an integral part of the National Health Policy. A key resolution called for introducing preventive and promotive oral health services from the village level onward. It recommended launching a pilot project on Oral Health Care during 1995-96 in five districts (one in each of five states).
• 1998-1999: The Ministry of Health & Family Welfare, in collaboration with the Directorate General of Health Services (DGHS), initiated the National Oral Health Care Programme (NOHCP) on a pilot basis. The Department of Dental Surgery at All India Institute of Medical Sciences (AIIMS), New Delhi, was designated as the nodal agency to implement it. This pilot focused on primary prevention of periodontal diseases and oral cancers, oral health education, and strengthening rural setups through IEC (Information, Education, and Communication) materials, mobile clinics, and community involvement.

These efforts marked the first organized government push beyond policy drafting.Early 2000s: Evidence Generation Through National SurveysReliable data became crucial for scaling up interventions.

• 2002-2003 / 2003-2004: The Dental Council of India (DCI), in collaboration with the Ministry of Health & Family Welfare, conducted India's first National Oral Health Survey and Fluoride Mapping. This landmark, scientific, state- and national-level study covered multiple states and examined oral health habits, diseases (dental caries, periodontal issues, fluorosis), and fluoride levels in water. It provided baseline prevalence data — e.g., high rates of untreated caries and periodontal disease — underscoring the urgent need for a structured national program.

This survey remains a foundational reference for oral health planning in India.2010s: Launch of the Full-Fledged National Oral Health ProgrammeThe program gained momentum during the 12th Five-Year Plan.

• 2012-2013: An expert group, steered by Dr. Jagdish Prasad (Director General of Health Services), reviewed the oral health situation and recommended a dedicated national program.
• 2014-15: The National Oral Health Programme (NOHP) was officially launched as a full national program under the National Health Mission (NHM) during the 12th Five-Year Plan. This marked the first time oral health received dedicated central funding and structure.
  • It operated through two main components: NHM (state-level delivery) for establishing dental units at district/sub-district levels via Programme Implementation Plans (PIPs), and central support for oversight, training, and IEC/BCC.
  • Initial rollout began in 9 states, with funds released for infrastructure, manpower, and services.
  • The National Oral Health Cell (NOHC) was established at the central level for coordination, monitoring, and prototype materials development.
  • Centre for Dental Education and Research (CDER), AIIMS, New Delhi, was designated as the National Centre of Excellence to assist in implementation, training, and research.

By 2015-16, states like Tamil Nadu began full-district implementation, and nodal officer meetings were held to review progress.Post-2020: Integration, Expansion, and ModernizationThe program evolved to align with broader health priorities amid the COVID-19 pandemic and national schemes.

• Post-2020: Greater emphasis on integrating oral health with Non-Communicable Diseases (NCDs) programs (e.g., NPCDCS for diabetes/cardiovascular links), National Tobacco Control Programme (NTCP) for oral cancer screening, and Ayushman Bharat (including Health and Wellness Centres for primary care). This reflects a shift toward holistic, preventive care and reducing silos.
• 2020s Ongoing: Expansion of dental units (thousands supported across PHCs, CHCs, SDHs, and DHs), enhanced IEC/BCC, PPP models with dental colleges, and monitoring via HMIS.
• 2024-26 Operational Guidelines: States like Assam prepared detailed RoPs (Record of Proceedings) targeting saturation of 200-250 Primary Health Facilities (PHFs) with dental services, focusing on infrastructure upgrades, manpower, consumables, outreach, and HMIS tracking for OPD and services. Emphasis on comprehensive care, school programs, and integration with tobacco cessation and cancer detection.

As of 2026, NOHP continues to evolve, with over 9,000+ dental units supported since inception, reflecting sustained commitment to equitable oral healthcare.This timeline illustrates a progressive shift: from policy advocacy in the 1980s, through pilots and evidence-building in the 1990s-2000s, to a robust, integrated national program since 2014-15. The National Oral Health Cell (NOHC) and CDER, AIIMS remain pivotal in central coordination and excellence. With ongoing alignment to Ayushman Bharat and NCD strategies, NOHP holds promise for significantly reducing India's oral disease burden in the coming years.

3. Core Objectives of the National Oral Health Programme (NOHP) – Expanded Explanation of Each GoalThe National Oral Health Programme (NOHP), launched in 2014-15 under the National Health Mission (NHM) by the Ministry of Health & Family Welfare (MoHFW), Government of India, is designed to tackle the country's high burden of oral diseases through a structured, integrated, and equitable approach. The program's objectives are clearly outlined in official operational guidelines and NHM documentation. They are practical, interconnected, and focused on long-term improvement rather than short-term fixes.These core objectives include:

1. To improve the determinants of oral health
2. To reduce morbidity from oral diseases
3. To integrate oral health promotion and preventive services with the general health care system
4. To encourage promotion of Public-Private Partnerships (PPP) model for achieving better oral health

Below is a detailed, expanded explanation of each objective, including rationale, strategies, implementation mechanisms, expected outcomes, and real-world relevance as of 2026.1. To Improve the Determinants of Oral Health

Detailed Explanation:

This foundational objective targets the root causes (or "determinants") that influence oral health status at the population level. Poor oral health in India is largely driven by modifiable risk factors such as high consumption of sugary foods and beverages, widespread tobacco and alcohol use (both smoked and smokeless forms like gutka and paan), inadequate oral hygiene practices, limited exposure to fluorides, and socioeconomic barriers that limit access to preventive care.

Key Strategies and Interventions:

• Community Education and Behavior Change: Through widespread Information, Education, and Communication (IEC) and Behavior Change Communication (BCC) campaigns, the program promotes healthy habits like brushing twice daily with fluoride toothpaste, reducing sugar intake, quitting tobacco, and regular dental check-ups.
• Risk Factor Reduction: Emphasis on tobacco cessation (synergized with the National Tobacco Control Programme – NTCP), alcohol moderation, and promotion of fluoride use (via toothpaste, mouth rinses, or community water/salt fluoridation where appropriate).
• Multi-Sectoral Coordination: Collaboration with related sectors like nutrition (to curb sugary diets), education (incorporating oral health in school curricula), and water supply (for fluoride monitoring).
• Targeted Outreach: Special focus on high-risk groups, including children (to prevent early childhood caries), pregnant women, diabetics, and tobacco users.

Expected Outcomes:

By addressing these upstream determinants, NOHP aims to prevent diseases before they occur, reducing the overall incidence of dental caries, periodontal diseases, and oral cancers. This preventive approach is cost-effective, as preventing one case of advanced periodontal disease or oral cancer saves significant treatment costs and improves quality of life.

Relevance in 2026: With rising NCDs (non-communicable diseases) like diabetes — which exacerbate oral issues — improving determinants remains critical for breaking the vicious cycle between oral and systemic health.2. To Reduce Morbidity from Oral Diseases

Detailed Explanation:

This objective directly tackles the high prevalence and impact of oral diseases, aiming to lower their incidence, severity, progression, and associated complications. In India, dental caries affects 50-65% of the population, periodontal diseases impact 80-90% of adults, and oral cancer (often tobacco-linked) has one of the world's highest burdens. Untreated conditions lead to pain, infections, tooth loss, nutritional issues, and links to systemic diseases (e.g., cardiovascular problems, preterm births).

Key Strategies and Interventions:

• Prevention: Application of fluoride varnish, pit-and-fissure sealants, oral prophylaxis (scaling), and school-based fluoride programs.
• Early Detection and Screening: Routine oral examinations, opportunistic screenings (especially for oral potentially malignant disorders in tobacco users), and integration with NCD screening camps.
• Curative and Rehabilitative Services: Provision of fillings, extractions, root canal treatments, dentures, and advanced care at higher facilities to prevent complications like abscesses or deformities from oral cancer surgery.
• Monitoring Morbidity Reduction: Use of Health Management Information System (HMIS) data to track dental OPD numbers, disease prevalence, and treatment coverage.

Expected Outcomes:

Significant decline in untreated caries, fewer extractions due to advanced decay, reduced periodontal pocket depths, and earlier detection of oral cancers for better survival rates. Overall, this objective seeks to minimize pain, disability, and economic loss from oral diseases.

Relevance in 2026: With ongoing emphasis on NCD integration, reducing oral morbidity contributes to broader health goals like lowering diabetes complications and improving productivity.3. To Integrate Oral Health Promotion and Preventive Services with the General Health Care System

Detailed Explanation:

Oral health has historically been siloed from general healthcare, leading to fragmented services. This objective seeks to embed oral health seamlessly into the existing public health infrastructure, ensuring "one-stop" care where patients receive dental services alongside other treatments.

Key Strategies and Interventions:

• Infrastructure Integration: Establishment and upgradation of dental units at Primary Health Centres (PHCs), Community Health Centres (CHCs), Sub-District Hospitals (SDHs), and District Hospitals (DHs).
• Manpower Synergy: Training general health workers (e.g., ANMs, ASHA workers, CHOs) in basic oral health promotion, screening, and referral. Dental professionals receive training for integrated care.
• Program Convergence: Linking NOHP with NPCDCS (NCDs), NTCP (tobacco control), school health programs, maternal/child health initiatives, and Ayushman Bharat Health and Wellness Centres (HWCs).
• Service Delivery Model: Comprehensive care — preventive, promotive, curative — delivered at the same facility level as other primary/secondary services.

Expected Outcomes:

Reduced silos, higher utilization of public facilities, better early referrals, and holistic patient management (e.g., diabetic patients getting oral checks to prevent complications).

Relevance in 2026: With Ayushman Bharat's expansion, this integration ensures oral health is no longer an afterthought but a core component of universal health coverage.4. To Encourage Promotion of Public-Private Partnerships (PPP) Model for Achieving Better Oral Health

Detailed Explanation:

Public sector resources alone are insufficient to cover India's vast population and rural-urban divide. This objective promotes collaboration with private entities to expand reach, quality, and innovation in oral health services.

Key Strategies and Interventions:

• Partnership Models: Collaboration with private dental colleges (for training, outreach, and advanced care), Indian Dental Association (IDA), NGOs, and community-based organizations.
• Joint Activities: Community camps, awareness drives, training programs, mobile dental units, and service delivery in underserved areas.
• Resource Sharing: Private institutions act as hubs for cessation services, research, and referral, while public funding supports consumables or infrastructure.
• Feasibility-Based Implementation: PPPs are encouraged where viable, especially in rural or tribal regions.

Expected Outcomes:

Increased service coverage, better manpower utilization, innovative approaches (e.g., tele-dentistry), and sustainable models for long-term impact.

Relevance in 2026: As public-private synergies grow under schemes like Ayushman Bharat, PPPs help bridge gaps in dentist availability and accelerate progress toward "optimal oral health for all."These four interconnected objectives form the backbone of NOHP, guiding its implementation from central oversight (via National Oral Health Cell) to grassroots delivery. By focusing on prevention, integration, equity, and collaboration, the program aims to transform India's oral health landscape — reducing preventable suffering and contributing to a healthier nation.

4. Detailed Components and Implementation Strategy of NOHP

The National Oral Health Programme (NOHP), launched by the Government of India in 2014 under the National Health Mission (NHM), aims to provide integrated, comprehensive oral health care in existing public health facilities across the country. Its core objectives include improving determinants of oral health, reducing morbidity from oral diseases, integrating oral health promotion and preventive services with the general health care system, and promoting Public-Private Partnership (PPP) models for better outcomes. As of 2026, the program has supported the establishment or upgrade of over 10,087 dental care units nationwide, covering 773 districts, with a focus on expanding access to underserved rural and urban populations. NOHP operates through two primary arms: state-level execution via NHM and central-level oversight.A. NHM Component – State-Level Core Delivery (Most Detailed Execution)Under the NHM framework, states and Union Territories submit detailed Programme Implementation Plans (PIPs) annually to the Ministry of Health and Family Welfare (MoHFW) for approval and central funding. These PIPs outline specific activities, budgets, and timelines tailored to regional needs, such as high prevalence of oral diseases in tobacco-heavy areas or underserved rural zones. Funding is disbursed based on these proposals, with states required to contribute matching funds under the NHM's 60:40 central-state sharing ratio (90:10 for special category states).Infrastructure Development: The program prioritizes setting up or upgrading dedicated dental units at various levels of public health facilities (PHFs), including District Hospitals (DH), Sub-District Hospitals (SDH), Community Health Centers (CHC), Primary Health Centers (PHC), and even Sub-Centers in high-burden areas. The target is to saturate all government facilities with functional dental units, ensuring at least one per district and extending to block levels. By FY 2025-26, the focus has been on expanding to additional PHFs, with operational guidelines emphasizing sustainable infrastructure like modular dental clinics for remote areas. This includes civil works for space allocation, electrical setups for equipment, and water supply for sterilization.Essential Equipment: Each dental unit is equipped with standardized tools to enable basic to intermediate care. Key items include a dental chair with unit, intra-oral X-ray machine, autoclave for sterilization, basic instruments (forceps, elevators, scalers), suction apparatus, and operating lights. Advanced setups in DHs may include RVG (radiovisiography) for digital imaging and ultrasonic scalers. Procurement is guided by IPHS (Indian Public Health Standards) norms to ensure quality and cost-effectiveness.Consumables: Annual financial support is provided for essential materials, including restorative composites, local anesthetics, pit and fissure sealants, fluoride varnishes, glass ionomer cements, and disposable items like gloves and masks. States manage procurement through centralized tenders or GEM (Government e-Marketplace) portals to address supply chain issues, with budgets allocated based on OPD footfall and projected needs.Manpower Provision: To bridge human resource gaps, NOHP allows contractual appointments of Dental Surgeons (BDS/MDS qualified), Dental Hygienists, and Dental Assistants. Terms of Reference (TORs) are clearly defined, including duties like patient consultations, procedures, outreach, and reporting. In rural areas, incentives like hardship allowances are offered to retain staff. Training modules under NOHP build capacity, with over 10,000 health workers trained annually on oral health integration.Service Delivery Activities: NOHP emphasizes comprehensive care across the spectrum:

• Preventive: Application of fluoride varnish, pit and fissure sealants, oral prophylaxis (scaling), and health education on hygiene.
• Curative: Restorations (fillings), extractions, root canal treatments, minor surgeries like disimpactions.
• Rehabilitative: Provision of partial or complete dentures, especially for elderly and low-income groups. Outreach includes school-based programs (e.g., dental screenings in over 100,000 schools annually), community screenings at health melas, door-to-door surveys in high-risk villages, and mobile dental units for remote areas. Integration with other programs like the National Tobacco Control Programme (NTCP) and National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) enables tobacco cessation counseling and oral cancer screening, with referrals to higher centers for biopsies or advanced care.

Funding Mechanism: States receive flexible grants based on PIP approvals, with examples from prior years showing allocations exceeding Rs 25 crore for multiple states like Assam and Tamil Nadu. For 2024-26, the emphasis is on expanding to more PHFs, with tracking via the Health Management Information System (HMIS) for metrics like dental OPD numbers (targeting 2.2 crore beneficiaries in FY 2025-26) and service coverage. Budgets under NHM's NCD component support this, though calls for a standalone NOHP line item persist for better transparency.B. Central Level Support – Oversight and Enabling FunctionsAt the national level, the National Oral Health Cell (NOHC) under MoHFW coordinates overall planning, resource allocation, and prototype development for Information, Education, and Communication/Behavior Change Communication (IEC/BCC) materials. This includes nationwide campaigns like millions of SMS alerts on oral hygiene, TV/radio spots, and digital posters distributed to states for localization.Training Programs: Standardized modules are rolled out for health workers, including ASHA (Accredited Social Health Activists), ANMs (Auxiliary Nurse Midwives), and medical officers, covering oral disease identification, basic interventions, and referral protocols. Nodal officer workshops at state and district levels ensure uniform implementation, with over 500 workshops conducted in recent years.Monitoring & Evaluation: A multi-tiered system operates from district to central levels, using HMIS indicators such as percentage of PHFs with dental services (target: 100% saturation), OPD footfall (averaging 20-50 patients per unit daily), procedure volumes, and disease prevalence data. Quarterly reviews and third-party audits help identify gaps, with digital tools like dashboards for real-time tracking.PPP Models: Dental colleges are positioned as hubs for advanced care, tobacco cessation centers, and training. Partnerships with NGOs and private providers extend services to remote areas, including mobile clinics and tele-dentistry pilots.

4. Detailed Components and Implementation Strategy of NOHP

The National Oral Health Programme (NOHP), launched by the Government of India in 2014 under the National Health Mission (NHM), aims to provide integrated, comprehensive oral health care in existing public health facilities across the country. Its core objectives include improving determinants of oral health, reducing morbidity from oral diseases, integrating oral health promotion and preventive services with the general health care system, and promoting Public-Private Partnership (PPP) models for better outcomes. As of 2026, the program has supported the establishment or upgrade of over 10,087 dental care units nationwide, covering 773 districts, with a focus on expanding access to underserved rural and urban populations. NOHP operates through two primary arms: state-level execution via NHM and central-level oversight.

A. NHM Component – State-Level Core Delivery (Most Detailed Execution)

Under the NHM framework, states and Union Territories submit detailed Programme Implementation Plans (PIPs) annually to the Ministry of Health and Family Welfare (MoHFW) for approval and central funding. These PIPs outline specific activities, budgets, and timelines tailored to regional needs, such as high prevalence of oral diseases in tobacco-heavy areas or underserved rural zones. Funding is disbursed based on these proposals, with states required to contribute matching funds under the NHM's 60:40 central-state sharing ratio (90:10 for special category states).

Infrastructure Development: The program prioritizes setting up or upgrading dedicated dental units at various levels of public health facilities (PHFs), including District Hospitals (DH), Sub-District Hospitals (SDH), Community Health Centers (CHC), Primary Health Centers (PHC), and even Sub-Centers in high-burden areas. The target is to saturate all government facilities with functional dental units, ensuring at least one per district and extending to block levels. By FY 2025-26, the focus has been on expanding to additional PHFs, with operational guidelines emphasizing sustainable infrastructure like modular dental clinics for remote areas. This includes civil works for space allocation, electrical setups for equipment, and water supply for sterilization.

Essential Equipment: Each dental unit is equipped with standardized tools to enable basic to intermediate care. Key items include a dental chair with unit, intra-oral X-ray machine, autoclave for sterilization, basic instruments (forceps, elevators, scalers), suction apparatus, and operating lights. Advanced setups in DHs may include RVG (radiovisiography) for digital imaging and ultrasonic scalers. Procurement is guided by IPHS (Indian Public Health Standards) norms to ensure quality and cost-effectiveness.

Consumables: Annual financial support is provided for essential materials, including restorative composites, local anesthetics, pit and fissure sealants, fluoride varnishes, glass ionomer cements, and disposable items like gloves and masks. States manage procurement through centralized tenders or GEM (Government e-Marketplace) portals to address supply chain issues, with budgets allocated based on OPD footfall and projected needs.

Manpower Provision: To bridge human resource gaps, NOHP allows contractual appointments of Dental Surgeons (BDS/MDS qualified), Dental Hygienists, and Dental Assistants. Terms of Reference (TORs) are clearly defined, including duties like patient consultations, procedures, outreach, and reporting. In rural areas, incentives like hardship allowances are offered to retain staff. Training modules under NOHP build capacity, with over 10,000 health workers trained annually on oral health integration.

Service Delivery Activities: NOHP emphasizes comprehensive care across the spectrum:

- Preventive: Application of fluoride varnish, pit and fissure sealants, oral prophylaxis (scaling), and health education on hygiene.

- Curative: Restorations (fillings), extractions, root canal treatments, minor surgeries like disimpactions.

- Rehabilitative: Provision of partial or complete dentures, especially for elderly and low-income groups.

Outreach includes school-based programs (e.g., dental screenings in over 100,000 schools annually), community screenings at health melas, door-to-door surveys in high-risk villages, and mobile dental units for remote areas. Integration with other programs like the National Tobacco Control Programme (NTCP) and National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) enables tobacco cessation counseling and oral cancer screening, with referrals to higher centers for biopsies or advanced care.

Funding Mechanism: States receive flexible grants based on PIP approvals, with examples from prior years showing allocations exceeding Rs 25 crore for multiple states like Assam and Tamil Nadu. For 2024-26, the emphasis is on expanding to more PHFs, with tracking via the Health Management Information System (HMIS) for metrics like dental OPD numbers (targeting 2.2 crore beneficiaries in FY 2025-26) and service coverage. Budgets under NHM's NCD component support this, though calls for a standalone NOHP line item persist for better transparency.

B. Central Level Support – Oversight and Enabling Functions

At the national level, the National Oral Health Cell (NOHC) under MoHFW coordinates overall planning, resource allocation, and prototype development for Information, Education, and Communication/Behavior Change Communication (IEC/BCC) materials. This includes nationwide campaigns like millions of SMS alerts on oral hygiene, TV/radio spots, and digital posters distributed to states for localization.

Training Programs: Standardized modules are rolled out for health workers, including ASHA (Accredited Social Health Activists), ANMs (Auxiliary Nurse Midwives), and medical officers, covering oral disease identification, basic interventions, and referral protocols. Nodal officer workshops at state and district levels ensure uniform implementation, with over 500 workshops conducted in recent years.

Monitoring & Evaluation: A multi-tiered system operates from district to central levels, using HMIS indicators such as percentage of PHFs with dental services (target: 100% saturation), OPD footfall (averaging 20-50 patients per unit daily), procedure volumes, and disease prevalence data. Quarterly reviews and third-party audits help identify gaps, with digital tools like dashboards for real-time tracking.

PPP Models: Dental colleges are positioned as hubs for advanced care, tobacco cessation centers, and training. Partnerships with NGOs and private providers extend services to remote areas, including mobile clinics and tele-dentistry pilots.

5. Target Beneficiaries and State-Level Success Stories

NOHP targets diverse groups to address India's high oral disease burden, where over 60% of adults suffer from untreated dental caries and periodontal diseases.

Children & Schools: Focus on early intervention to reduce Early Childhood Caries (ECC) through fluoride applications and sealants in school camps, reaching millions annually and preventing long-term issues.

Rural & Marginalized: Bridges access gaps in underserved areas via mobile units and outreach, benefiting low-income farmers, tribal communities, and migrant workers with free services.

High-Risk Groups: Tobacco users receive integrated screening and cessation support through NTCP synergy, targeting oral cancer prevention in high-prevalence states like Uttar Pradesh and Bihar.

General Population: Offers free or low-cost services at public facilities, including urban poor through Ayushman Arogya Mandirs.

State highlights (based on available implementation data up to 2026):

- Tamil Nadu: Achieved comprehensive coverage across all districts since 2015-16, with over 1,000 dental units operational and high OPD utilization; integrated with state NCD programs for oral cancer screening.

- Assam: Under 2024-26 guidelines, targeted 108+ institutions in 34 districts, establishing functional units in remote areas and conducting widespread IEC campaigns; recognized as a top performer in 2025 for outreach.

- Himachal Pradesh: An early adopter with strong rural outreach, covering hilly terrains via PPP mobile clinics; reported over 50% increase in dental OPDs post-NOHP upgrades.

- Additional examples: Nagaland held state review meetings and trainings for dental surgeons in 2025, while Puducherry's campaign reached 222,000 people through innovative activities like street theatre. Tripura and Delhi have expanded school camps and geriatric care under NOHP.

6. Persistent Challenges in Implementation (2025-2026 Insights)

Despite scaling to over 10,000 units, NOHP faces ongoing hurdles as of 2026, exacerbated by India's diverse geography and socioeconomic disparities.

Resource Constraints: Limited funding (per capita oral health spend ~5 INR), manpower shortages (dentist-to-population ratio 1:10,000 in rural areas), and infrastructure gaps in remote regions hinder full saturation.

Low Utilization: Only ~13-25% of the population seeks public dental care due to low awareness, preference for private providers, and stigma around oral health; rural CHCs report underutilization despite upgrades.

Supply Chain Issues: Procurement and distribution delays for consumables like GIC and anesthetics disrupt services, with excess stock in some areas and shortages in others.

Integration Gaps: Limited synergy with NTCP/NPCDCS and broader NCD programs; rural dentist shortages persist, with many positions vacant due to urban preferences.

Monitoring Weaknesses: Inadequate surveillance and data quality in HMIS, lacking real-time analytics for disease trends; transparency issues from no dedicated NOHP budget line.

Other factors include high out-of-pocket costs (62% of health expenses), uneven ABDM integration, and competing priorities in public health systems.

7. The Road Ahead in 2026 and Practical Tips

Looking to 2026 and beyond, NOHP is poised for deeper integration with Ayushman Bharat schemes, including ABDM for digital health records and PM-JAY for covering advanced dental procedures. Plans include AI-driven predictive analytics for oral disease hotspots, expanded PPP for tele-dentistry, mobile apps for self-assessments, and a stronger prevention focus via community-level interventions. Budgets aim to increase transparency with dedicated allocations, targeting UHC by 2030 aligned with WHO goals.

Protect yourself:

- Brush twice daily with fluoride toothpaste for at least two minutes, using a soft-bristled brush.

- Floss daily and limit sugary foods, beverages, and tobacco to prevent caries and gum disease.

- Seek NOHP services at your nearest government facility for free check-ups and treatments.

- Quit tobacco — join NTCP cessation programs and get regular oral cancer screenings.

Conclusion

The National Oral Health Programme (NOHP) represents a landmark step towards making comprehensive, accessible, and affordable oral healthcare a reality for every Indian citizen. By strengthening public health infrastructure, integrating preventive and curative services, and fostering partnerships, NOHP has already established over 10,000 functional dental units and served millions, particularly children, rural populations, and high-risk groups. Despite persistent challenges like manpower shortages, low awareness, and supply chain gaps, the programme’s steady expansion and integration with Ayushman Bharat signal a promising future. With continued focus on prevention, digital monitoring, and community engagement, NOHP holds the potential to significantly reduce the oral disease burden and contribute to India’s journey towards Universal Health Coverage. A healthier smile for every Indian is no longer a distant dream — it is an achievable goal within reach. NOHP offers real hope for a healthier India by making oral care accessible and preventive. Share your thoughts! 🦷National Oral Health Programme (Awareness for Infants/Children)
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