Oral health is a part of overall health, well-being, nutrition, communication, and quality of life.[1] Despite this, oral diseases are one of the most common non-communicable diseases in the world and continue to disproportionately impact socially and economically disadvantaged communities.[2] Oral diseases are estimated to affect about 3.5–3.7 billion people worldwide, and untreated dental caries, periodontal diseases, tooth loss, and oral cancers are estimated to be significant contributors to this burden.[2]  An estimated 2.5 billion people suffer from untreated dental caries (cavities), and 1 billion people suffer from severe periodontal disease (gum disease) around the world.[3] Importantly, most oral diseases are preventable and can be identified and treated effectively if diagnosed

in the early stages.[4]

It is important to note that the burden of oral diseases is especially high in LMICs, where prevention and restorative dental care are not available for everyone.[5] There is a high level of inequality in oral healthcare provision, with 75% of individuals with oral diseases living in low and middle income countries.[6] At the same time, the number of people suffering from oral disease around the world has grown by some 1 billion in the last 30 years, reflecting the increased need for readily available preventive and treatment options.[7] There are several barriers to dental care, including lack of oral health professionals, healthcare systems, transportation issues, and out-of-pocket expenses, which the WHO has noted are significant. These challenges are especially applicable to rural and remote communities, which can be far away from dental services.[8]

Rural communities often lack dental resources, have less dental health literacy, less financial means, and health-seeking behaviour is slower. Therefore, dental caries and periodontal disease may not be treated, unless they are the source of pain, infection, functional limitations, or tooth loss.[9] Additionally, oral lesions that could be indicative of potentially malignant conditions and early oral cancers might not be identified, as oral examinations are rare among underserved groups.[10] It is estimated that there are around 380,000 new cases of oral cancer each year and that early recognition of a suspicious oral lesion and referral are important.[11] The ability to detect many oral conditions through a relatively simple clinical examination and to treat them with cost-effective interventions at the primary healthcare level means that providing access to screening and early treatment is an important public-health strategy.[12]

Mobile dental camps are a possible solution to the geographical and infrastructural challenges by taking oral health care to the people instead of people travelling to the established dental care centers.[13] These programmes can include oral screening, risk assessment, oral-health education, preventative activities and basic treatment as part of a one-stop community-based intervention.[14] Mobile dental services are feasible in underserved rural communities.[15]

Although community-based and mobile dental services have been identified as potential solutions, a study is needed to assess if mobile dental camps can yield quantifiable results in terms of diagnosis and treatment of oral diseases among the rural population. Delivering dental care to the doorsteps of underserved communities can change the nature of oral care from a mostly reactive service to a proactive, preventive, and early detection, timely intervention service. Based on this, the present interventional study was planned to evaluate the effectiveness of mobile dental camps for early detection and treatment of oral diseases among people living in rural populations and to find out whether this mobile outreach service can be a viable and effective strategy to address the unmet oral healthcare needs.

A community-based interventional study was conducted for a period of six months from Octuber, 2025 to March 2026. The sample size was determined to estimate a single population proportion with OpenEpi version 3.01. In the absence of any reliable local estimates of the proportion of people with undiagnosed or untreated oral disease who could be identified at a mobile dental camp, an assumed oral disease prevalence of 50% was used to determine the maximum sample size needed.[16] A calculated sample size of 196 participants was used at a 95% confidence level and 7% margin of error. A final sample size of 216 participants was estimated to be required after allowing 10% for non-response and loss to follow-up. A non-probability consecutive sampling technique was used. Permanent residents of the communities selected, who attended the mobile dental camps during the study period, were included. Informed consent was required and participants had to agree to the indicated dental treatment or referral and to take part in the planned follow-up assessment. The participants who had clinically identified dental caries, periodontal disease, oral mucosal lesions, oral potentially malignant disorders, and other treatable oral condition were eligible for assessment and intervention. Those who refused informed consent, could not co-operate sufficiently with the oral examination, or were medically not stable and needed immediate medical management instead of dental management were excluded. To reduce the risk of recent dental treatment affecting findings from the mobile camp's effectiveness, patients who had had comprehensive dental treatment in the last three months were excluded. People with complicated procedures which could not be safely carried out in the mobile dental office were assessed and referred for subsequent treatment, but not included in analyses of treatment provided directly in the camp. All participants gave informed written consent after obtaining approval from the appropriate institutional review committee. Demographic characteristics, previous dental visits, dental-care utilization, tobacco and other relevant risk habits, presenting complaints, previous history of oral disease, and oral hygiene practices were recorded using a structured data collection proforma. All the participants were evaluated intraorally with a standard examination by a trained dental surgeon under the adequate lighting of the room, with the use of the sterilized instruments. Dental caries were recorded on the DMFT score, and periodontal status was clinically evaluated by standardised periodontal criteria. Systematic examination of the oral mucosa was performed for the presence of ulcers, white or red lesions, swellings, pigmentation and other abnormal lesions that could be considered suspicious for potentially malignant or malignant disease. Oral-health education and appropriate treatment based on the clinical findings were provided to the participants after the baseline assessment. Preventive and basic therapeutic services consisted of oral hygiene instruction, scaling and polishing, fluoride application as needed, fissure sealants as needed, restorations, and simple extractions. Oral lesions of any nature suspected of being suspicious were advised and referred to an appropriate dental facility; complicated dental infections and advanced periodontal disease were counselled and referred to an appropriate dental facility. The mobile dental programme therefore included early detection and immediate treatment, not just a screening. This model was similar to previous mobile dental programmes that provided examinations, health education, preventive care, restorations, extractions, and minor oral surgical procedures in underserved communities. A follow-up assessment took place around 4-weeks after the camp. Community health workers or telephone were used to contact participants. On follow-up, treatment completed, symptom persistence or improvement, resolution of infection or pain, referrals were completed, and the need for further dental care was recorded. The main outcome was the effectiveness of the mobile dental camp in detection of oral diseases that were not previously diagnosed and treatment of the identified diseases. Secondary outcomes were the percentage of people who were treated, the percentage of people who completed treatment, the percentage of people who were referred and the percentage of people who experienced a change in their oral health care needs. The entered and analyzed data were analyzed using IBM SPSS Statistics version 24. Continuous variables were tested for normality using the Shapiro-Wilk test and are reported as mean ± SD (standard deviation) for variables that were normally distributed and median and IQR (interquartile range) for variables that were skewed. Frequencies and percentages were used for summarising categorical variables. The prevalence of each oral disease, treatment needs, treatment received, and referral needs were derived and estimated within 95% confidence intervals. The Chi-square test and Fisher's exact test were used to determine associations between categorical demographic variables and oral disease status. The independent variable was used the independent variable. McNemar test was used to measure changes in paired categorical outcomes before and after the intervention, and the paired t-test was used to compare paired continuous measurements before and after the intervention. A p-value <0.05 was considered statistically significant.

A total of 216 participants were included, with a mean age of 42.6 ± 14.8 years. There were 56.0% females and 44.0% males in the study population. Most of the participants reported low frequency of dental visits (38.0% had never visited a dentist and 44.0% had not visited a dentist in the last 12 months). Oral hygiene was poor, and 28.2% said they used tobacco. The mean DMFT score was 5.8 ± 3.7, while the mean periodontal score was 2.4 ± 0.9 (Table 1).

In 75.9% (164) participants, oral disease was identified. Dental caries was the more common condition (54.6%), followed by periodontal disease (47.7%). Scaling and polishing was needed by 61.1% of participants, specialist referral by 17.1%, and restorative treatment by 44.9%. In the 6.5% of those participants with potentially malignant or malignant lesions, these were identified as suspicious (Table 2).

Oral disease was significantly related to older age, less education, having seen a dentist previously, not brushing teeth as often, and the use of tobacco (all p<0.05). The prevalence of the disease rose from 57.8% among the age group 18-29 years to 92.5 per cent in those aged ≥60 years. There was no significant association with sex (p=0.182) (Table 3).

There were statistically significant differences between age means, DMFT, periodontal score, and the number of teeth needing treatment between the participants with oral disease and those without. The mean DMFT score of the participants with disease was 6.5 ± 3.5 teeth, whereas corresponding score in the participants without disease was 3.6 ± 2.8 (p<0.001), and the mean periodontal score of the participants with disease was 2.8 ± 0.7, whereas mean periodontal score of the participants without disease was 1.9 ± 0.8 (p<0.001) (Table 4).

After screening, oral-health education was given to all the participants, scaling/polishing was performed on 132(61.1%) participants, and simple extraction was performed on 46(21.3%) participants. All the participants received oral health education after screening, simple extraction was performed on 46(21.3%) participants, and scaling/polishing was performed on 132(61.1%) participants. In total, 159 (73.6%) were treated at the camps, and 37(17.1%) were referred for specialist treatment. At four-week follow-up, 139(64.4%) had completed treatment, and 29 of 37 (78.4%) had completed their referrals; pain or infection had resolved in 90.6% of treated participants (Table 5).

All primary short-term outcomes were significantly improved by four weeks. Untreated oral disease decreased from 75.9% to 11.6%, unmet treatment needs from 82.9% to 22.2%, dental pain from 32.9% to 5.6%, and acute infection from 9.7% to 1.4% (all p<0.001). The change in mean periodontal score also showed a significant improvement from 2.4±0.9 to 2.0±0.8 (p<0.001), while there was no significant change in mean DMFT score (p=0.284) (Table 6).

Table 1. Baseline demographic and oral-health characteristics of participants (n=216)

Table 2. Oral diseases detected and treatment requirements at baseline (n=216)

Table 3. Association of demographic and behavioral characteristics with presence of oral disease

Table 4. Comparison of clinical oral-health measures according to disease status

Table 5. Treatment provided through mobile dental camps and four-week follow-up outcomes

Table 6. Effectiveness of mobile dental camps on oral-health outcomes

In the present interventional study, a significant burden of oral disease among the rural population was observed, and it was concluded that mobile dental camps could offer a viable platform for rural-urban linkage for the provision of oral screening services, prevention, and basic treatment. At baseline, 75.9% of the 216 participants had at least one clinically detected oral disease, with dental caries (54.6%) and periodontal disease (47.7%) being the most common. Importantly, before the intervention, 82.9% had an unmet need for dental treatment. After the mobile dental camp and four-week follow-up, untreated oral disease was reduced to 11.6% and unmet treatment needs reduced to 22.2%. There was also a considerable reduction in dental pain and acute infection. The results reported here suggest that the benefit of mobile dental camps is not restricted to diagnosis and identification of the disease, but with immediate basic treatment, education, and referral, a significant amount of untreated disease can be treated within a short span of time. The current study findings were similar to Aamer et al. (2022), who studied 1,025 school children of urban, peri-rural and rural areas of Rawalpindi, Pakistan for dental caries prevalence. They found that 66.1% of 6-year-olds and 71.3% of 12-year-olds had caries, especially in primary teeth, and that 78.7% of 6-year-olds and 79.7% of 12-year-olds had untreated caries. Their results highlighted the importance of active caries-management approaches in the rural and peri-rural population.[17] The present study also found that dental caries was the most common oral disease (affecting 54.6% of participants), and that a mobile service could translate detection of this significant disease burden into the provision of treatment. The slightly lower prevalence in our mostly adult population may be due to age differences or differences in dentition or dietary exposure, as well as differences in study methodology and not due to a lower burden of disease. The results are also similar to Rasool et al. (2026), who assessed 160 underprivileged children in a community dental outreach camp in Lahore. All the children had dental caries (70.0%, and the highest proportion of these was untreated caries (DMFT/DEFT scores). Once-daily tooth brushing, frequent consumption of sugary snacks, and parental illiteracy were significant associated factors with caries.[18] Likewise, the frequency of tooth brushing was related to the presence of oral disease in our study; those who brushed less than once a day were more likely to have oral disease (92.3%) than those who brushed twice a day (60.8%) (p<0.001). The findings here are consistent with those of earlier studies and indicate that mobile dental camps are not just treatment centers but should incorporate repeated oral hygiene education and behavior modification to target factors that contribute to subsequent disease. Delivering services directly to those who are underserved is highly recommended in light of the findings from Bala et al. (2023), who studied a mobile dental clinic in rural India over three years. The services offered by their programme were used by 6,326 patients, of whom 93.3% had never had any dental treatment before. The mobile unit was used to deliver oral examinations, scaling, restorations, fluoride treatment and extractions. The percentage of respondents who had never seen a dentist, or who had not seen a dentist for over a year, was also large.[16] In addition, our approach included oral examination, scaling, fluoride application, restoration, extraction and specialist referral, which was very similar to the comprehensive service model outlined by Bala et al. This experience and our significant decrease in untreated disease show that mobile dental services are viable to bridge geographical and service-access barriers.[16] The results are also consistent with those of Marples and Wright (2022), who reported on the provision of a mobile dental service to vulnerable communities in Bradford, United Kingdom, over 16 years. Their report highlighted the need for early care for vulnerable people and the role of mobile dental units as an effective method of delivering care outside of the traditional clinical environment. This is especially significant in the context of our finding that 38.0% of participants had never visited a dentist before and that 44.0% had not visited a dentist for over a year. The ability of a mobile unit to eliminate transportation and appointment barriers may thus enable a person who does not engage in the formal dental health care system to have an examination and treatment.[19] This marked a tremendous improvement in periodontal health that was seen in our study was further supported by a randomized controlled trial conducted in 2024 amongst 5000 children in a rural setting in Bhopal, India to assess a comprehensive school-based oral health intervention. The intervention group showed significant reduction in Community Periodontal Index, Gingival Index, and Plaque Index after 6 months compared to the controls.[20] The direction of effect was similar to that in that study, which also used children, but the length of intervention time was longer than the four-week follow-up period in our study. Our mean periodontal score decreased from 2.4 ± 0.9 to 2.0 ± 0.8 (p<0.001). The consistency of these results indicates that consistent oral health education and clinical preventive services interventions can lead to measurable improvements in periodontal health, but greater follow-up is needed to produce lasting periodontal benefits. The association between access to dental services and buildup oral disease documented in our study is also corroborated by a recent study of adults visiting a charitable mobile dental clinic in rural Al Madinah Province, Saudi Arabia in 2024. Of 414 participants, 412 had dental caries and the median DMFT was 13. Older age showed a significant positive association with DMFT, while visiting a dentist showed a significant negative relationship with DMFT (p<0.001). Also, more years of education were correlated with lower DMFT.[21] In our study, older age and lower educational attainment were also related to oral disease. Disease was significantly more common among participants who were older than age 60 years (92.5%) than among the 18- to 29-year-old participants (57.8%), and among participants who did not have a formal education. This research confirms the need to focus UPOP outreach programmes on older and educationally disadvantaged people in rural areas. In 2024, further evidence from Guangxi, China, confirms that community-based dental programmes could benefit from preventive interventions. A randomized controlled trial (RCT) was performed with 1,335 children in remote rural areas that compared the use of fluoride varnish-based caries prevention with oral health education and distribution of toothbrushes and toothpaste.[22] In this study, the economic benefit of fluoride-based prevention was specifically addressed in rural populations. In our mobile camps, fluoride application and oral-health education were also integrated, but in addition to restorative and extraction services. This integrated approach could be especially beneficial in resource-limited areas, as it treats an existing disease and prevents the emergence of a new one. The role of community-based workforce models was highlighted by Pourat et al. (2025) in Southeast Alaska. Their interrupted time-series study compared employment of primary dental health aides in remote communities and discovered that children who were served in the intervention system were significantly more likely to receive fluoride varnish, and that there were differences in the use of restorative treatment. The authors found there was potential for alternative oral-health practitioners to enhance the provision of preventive care in geographically isolated groups.[23,24] Our findings build upon this concept by reflecting that a mobile dental team can offer both preventive and direct treatment and referral. Dental pain, infection, and untreated disease were significantly lower, suggesting that outreach services might be even more useful when preventive and therapeutic services are combined, rather than preventive and therapeutic services being provided separately. Another benefit of mobile dental camps is early detection of any serious oral disease. In Pakistan, 10 oral cancer screening camps were organized, reaching 1,300 people in a multicentre community-based programme in 2025 in high-risk peri-urban and rural areas. Biopsy was performed on suspected lesions, and participants were counselled and referred for treatment of risk factors.[25, 26] In our study, there were 24 cases of oral mucosal lesions (11.1%), and 14 cases were lesions that were judged to be suspicious for potentially malignant or malignant oral disease that required specialist referral (6.5%). The current study was not a trial of an oral cancer screening program, but the results of this study show the value of mobile camps as an additional diagnostic measure. Regular screening of healthy community members may be able to detect lesions that may not have been noticed until symptomatic or advanced. A 2025 study by the Global Survey of 1,550 patients and 1,320 dentists from Pakistan, India, Bangladesh, Iran, and Saudi Arabia backs the greater acceptance of portable dental services. 75.3% of patients were willing to use portable dental services and 74% of dentists felt that portable dentistry could help to meet the dental needs of patients, especially in underserved areas.[27] This adds to the practical application of our results, because the success of a mobile dental programme is not only dependent on its clinical skills but also on the willingness of the community to accept the programme. Community-based dental services can mitigate logistical obstacles and may enhance participation of populations that are not routinely visiting traditional dental services. Limitations There were a number of limitations to the study. The first limitation was that the group was pre-intervention and post-intervention without a parallel control group, which precluded establishing a causal link between the mobile dental camp and the gains in the observed outcomes. Second, there was some selection bias as those who attended the camps may have been different from those residing in rural areas who did not attend. Third, the four-week follow-up was brief; thus, the study was unable to assess the long-term durability of treatment compliance, periodontal improvement, and preventive behavior change. Fourthly, some participants with the need for specialist treatment may not have finished referrals, which could be an underestimate of the overall treatment needs. Finally, the study was carried out in specific rural communities, and the results might not be applicable to other geographical and socio-economic contexts.

The mobile dental camps revealed a significant prevalence of untreated oral disease in the rural people and were an effective mechanism to provide accessible preventive and basic therapeutic dental care to the rural people. The results of the intervention showed statistically significant improvement in several measures of oral-health outcomes, including a significant decrease in the prevalence of untreated oral disease, unmet treatment demands, dental pain, acute infection, and periodontal scores in the short term. The presence of suspicious oral lesions further reinforced the importance of using mobile services to help identify and refer potentially serious oral conditions in the early stages. A combination of mobile dental camps, community education and existing referral mechanisms could be a feasible approach to address and reduce oral-health inequalities in rural populations