Progressive realisation of universal access to oral health services: what evidence is needed?

### Summary box In May 2021, the 74th World Health Assembly adopted a resolution on oral health,1 14 years after its last resolution on oral health (WHA60.17) in 2007,2 with slow progress on access to oral health services. The lack of global-level indicators for oral health monitoring is one of the major deficiencies in driving national and global universal health coverage (UHC) agendas on oral health. Prevalence of untreated oral diseases has increased over the last two decades,3 and the global prevalence rate of oral disorders was ranked first among all diseases since 1990. The rate increased from 43 634 cases per 100 000 population in 1990 to 45 035 cases per 100 000 population in 2019.4 Oral health services are expensive5 and usually not included in6 or are only partially covered by UHC benefit packages.7 This results in either high levels of out-of-pocket payments or high incidence of unmet needs, affecting vulnerable populations. For these reasons, private insurance shifts in to cover oral health costs in high-income countries.8 Only 35% of people with oral health problems in low-income countries were able to receive treatment within a year, whereas the rate was as high as 82% in high-income countries.9 Out-of-pocket expenditure for oral health services is …