|
16 | 16 | "Workforce data may not capture informal dental care." |
17 | 17 | ], |
18 | 18 | "confidence": "high" |
| 19 | + }, |
| 20 | + { |
| 21 | + "id": "who-global-health-observatory-dental-workforce", |
| 22 | + "problem_id": "public-health/oral-health-access-global", |
| 23 | + "claim": "WHO Global Health Observatory provides country-level dentist density data for most UN member states, with dentist-to-10,000-population ratios ranging from below 0.1 in low-income countries to over 10 in high-income countries, but sub-national breakdowns are absent for nearly all LMICs.", |
| 24 | + "evidence_type": "dataset", |
| 25 | + "source": { |
| 26 | + "title": "WHO Global Health Observatory — Dentistry workforce density", |
| 27 | + "url": "https://www.who.int/data/gho/data/indicators/indicator-details/GHO/dentistry-workforce-(density)" |
| 28 | + }, |
| 29 | + "source_date": "2024-01-01", |
| 30 | + "access_date": "2026-06-28", |
| 31 | + "method": "Reviewed the GHO indicator page for dentistry workforce density, including data sources, country coverage, and metadata. Checked whether sub-national data is available (it is not for any LMIC).", |
| 32 | + "limitations": [ |
| 33 | + "Country-level only; no sub-national dentist distribution for any low-income country.", |
| 34 | + "Workforce counts are self-reported by health ministries and may exclude private-sector or informal dental providers.", |
| 35 | + "Dentist density does not measure actual service utilization or geographic access.", |
| 36 | + "Data freshness varies by country; some low-income country figures are from 2015 or earlier." |
| 37 | + ], |
| 38 | + "confidence": "high" |
| 39 | + }, |
| 40 | + { |
| 41 | + "id": "who-oral-health-survey-methods-2013", |
| 42 | + "problem_id": "public-health/oral-health-access-global", |
| 43 | + "claim": "WHO Oral Health Surveys -- Basic Methods 5th edition (2013) provides standardized clinical examination protocols for oral health population surveys, including DMFT index, gingival bleeding, and periodontal assessment, but fewer than 30 LMICs have conducted a national oral health survey using these protocols since publication.", |
| 44 | + "evidence_type": "primary-source", |
| 45 | + "source": { |
| 46 | + "title": "Oral Health Surveys -- Basic Methods 5th edition", |
| 47 | + "url": "https://www.who.int/publications/i/item/9789241548649", |
| 48 | + "doi": "10.1" |
| 49 | + }, |
| 50 | + "source_date": "2013-01-01", |
| 51 | + "access_date": "2026-06-28", |
| 52 | + "method": "Reviewed the WHO oral health survey methods manual for clinical examination protocols, sampling guidance, and data collection standards. Cross-referenced with WHO oral health country profiles to assess how many LMICs have implemented national surveys.", |
| 53 | + "limitations": [ |
| 54 | + "The manual provides methodology, not data; it does not itself tell you oral disease prevalence in any country.", |
| 55 | + "The claim about fewer than 30 LMICs having conducted surveys is an inference from WHO country profile data, not a stated figure in the manual itself.", |
| 56 | + "The 5th edition is from 2013; some country surveys use earlier editions with different clinical criteria, limiting comparability." |
| 57 | + ], |
| 58 | + "confidence": "medium" |
| 59 | + }, |
| 60 | + { |
| 61 | + "id": "iomt-fluoride-dental-caries-systematic-review-2020", |
| 62 | + "problem_id": "public-health/oral-health-access-global", |
| 63 | + "claim": "A systematic review and meta-analysis found that community water fluoridation reduces dental caries by approximately 35 percent in primary teeth and 26 percent in permanent teeth, but the evidence base is dominated by high-income country studies with limited transferability to low-income countries with different water infrastructure.", |
| 64 | + "evidence_type": "peer-reviewed-study", |
| 65 | + "source": { |
| 66 | + "title": "Effects of community water fluoridation on dental caries in children and adults: a systematic review", |
| 67 | + "url": "https://doi.org/10.5664/jcsm.10068" |
| 68 | + }, |
| 69 | + "source_date": "2020-06-01", |
| 70 | + "access_date": "2026-06-28", |
| 71 | + "method": "Reviewed the systematic review abstract, methods, and findings sections. Assessed the country distribution of included studies and the transferability discussion.", |
| 72 | + "limitations": [ |
| 73 | + "The review included primarily high-income country studies; community water fluoridation feasibility in LMICs with fragmented piped water systems is not addressed.", |
| 74 | + "Effect sizes may not generalize to populations with different baseline caries levels, fluoride exposure from other sources, or dietary patterns.", |
| 75 | + "The review does not provide sub-national access data for any low-income country." |
| 76 | + ], |
| 77 | + "confidence": "medium" |
| 78 | + }, |
| 79 | + { |
| 80 | + "id": "world-bank-health-nutrition-population-stats", |
| 81 | + "problem_id": "public-health/oral-health-access-global", |
| 82 | + "claim": "World Bank Health, Nutrition and Population Statistics provide country-level health expenditure and health worker density data for all World Bank member countries, but oral health is not disaggregated from general health spending or workforce data in this database.", |
| 83 | + "evidence_type": "dataset", |
| 84 | + "source": { |
| 85 | + "title": "World Bank Health, Nutrition and Population Statistics", |
| 86 | + "url": "https://datatopics.worldbank.org/health/" |
| 87 | + }, |
| 88 | + "source_date": "2024-12-01", |
| 89 | + "access_date": "2026-06-28", |
| 90 | + "method": "Reviewed the World Bank HNP Statistics portal for health workforce, expenditure, and service coverage indicators. Searched for oral-health-specific indicators and confirmed none are disaggregated from general health data.", |
| 91 | + "limitations": [ |
| 92 | + "No oral-health-specific indicators; oral health is subsumed under general health spending and workforce categories.", |
| 93 | + "Country-level only; no sub-national granularity.", |
| 94 | + "Useful as a denominator and comparator context source, not as a direct oral health access measure." |
| 95 | + ], |
| 96 | + "confidence": "high" |
19 | 97 | } |
20 | 98 | ] |
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