Social determinants, conflict, and displacement: reframing oral health in humanitarian action

Abstract

Oral health is a fundamental component of overall health, yet it remains chronically excluded from humanitarian response frameworks. Displaced populations, including refugees and internally displaced persons (IDPs), experience a disproportionate burden of untreated oral disease, resulting in preventable pain, tooth loss, and systemic complications. Conflict and forced displacement intensify social determinants of health—transforming food insecurity, limited access to safe water, and the collapse of healthcare systems into acute risk factors for oral disease. Illustrative examples from diverse humanitarian contexts demonstrate how structural determinants such as malnutrition, attacks on health infrastructure, and psychosocial trauma converge to heighten oral health neglect. Despite well-established links between oral and systemic health, oral care remains absent from major humanitarian standards such as the Sphere guidelines and is underrepresented in UNHCR programming. Evidence also shows that low-cost, minimally invasive measures—such as daily oral hygiene support, fluoride use, and basic emergency dental interventions—are feasible even in fragile settings. This Perspective calls for urgent recognition of oral health as integral to humanitarian health policy and practice. Humanitarian actors, donors, and governments must ensure that oral health is systematically incorporated into emergency preparedness, response, and recovery. Integration with existing platforms—including maternal and child health, non-communicable disease services, and primary healthcare—offers practical and scalable entry points. Positioning oral health within humanitarian systems is both feasible and ethically imperative: a necessary step to relieve suffering, uphold dignity, and advance health equity for displaced populations worldwide.