The Missing Piece: Oral Health in Humanitarian Guidelines

Humanitarian crises, including armed conflicts, natural disasters, and displacement, often exacerbate existing health inequities. While the SPHERE Standards provide comprehensive guidelines for humanitarian responses, oral health remains conspicuously absent from their framework. The lack of oral health services in these settings contributes to the burden of untreated dental diseases, pain, and systemic health complications, particularly among vulnerable populations (Alemayehu, et al. 2019; Ayo-Yusuf & De Wet, 2016) [1, 3]. This article examines the need for incorporating oral health into the SPHERE Standards and offers evidence-based strategies for its implementation.

The Burden of Oral Diseases in Humanitarian Crises

Oral diseases, including dental caries, periodontal diseases, and oral trauma, disproportionately affect vulnerable populations in humanitarian settings. These conditions often go untreated due to a lack of resources, infrastructure, and trained personnel (Alemayehu, et al. 2019; Borelli, et al. 2020) [1, 4]. Refugee camps and conflict zones frequently experience overcrowding, poor sanitation, and limited access to nutrition, all of which exacerbate oral health challenges (Ayo-Yusuf & De Wet, 2016) [3]. Research also underscores the impact of inadequate water intake on oral health, particularly in resource-scarce environments {1}.

In addition to the physical challenges, psychological trauma associated with displacement and conflict further compounds oral health neglect. Stress-related behaviors, such as teeth grinding or poor hygiene practices, are commonly observed in these populations, leading to worsening oral health outcomes (Borelli, et al. 2020) [4]. Addressing these interconnected factors is essential for improving overall well-being.

Current Gaps in Humanitarian Guidelines

The SPHERE Standards serve as a global benchmark for quality and accountability in humanitarian response. However, they currently lack specific guidelines for addressing oral health. This oversight perpetuates a cycle of neglect, where oral health needs are overlooked in favor of other health priorities (World Health Organization, 2022; Alemayehu, et al. 2019) [1, 5]. Furthermore, the absence of oral health considerations undermines efforts to achieve equity and comprehensive care in humanitarian settings.

The World Health Organization (2022) [5] highlights the need for integrating oral health into broader health care strategies. Their global strategy on oral health underscores the critical role of oral health in achieving UHC, particularly in emergency contexts. Including oral health in the SPHERE Standards would ensure that essential dental services are recognized and prioritized alongside other health interventions.

The Case for Integrating Oral Health into SPHERE Standards

Oral health is integral to overall health and aligns with the global goal of achieving UHC. Poor oral health has far-reaching implications, including its impact on nutrition, systemic diseases, and quality of life. Malnutrition, for instance, is closely linked to oral health issues, as pain and infection can impair chewing and digestion (Ayo-Yusuf & De Wet, 2016) [3]. In emergencies, where access to balanced nutrition is already compromised, addressing oral health becomes even more critical {1}.

Integrating oral health into SPHERE Standards would:

• Promote holistic health care in humanitarian settings.

• Reduce the burden of untreated oral diseases.

• Address systemic health issues linked to poor oral health, such as malnutrition and cardiovascular diseases.

• Enhance the overall effectiveness of humanitarian health interventions by prioritizing comprehensive care.

Recommendations for Implementation

1. Capacity Building: Train humanitarian health workers in basic oral health care, including preventive and emergency dental procedures (Ayo-Yusuf & De Wet, 2016) [3]. Workshops and online courses can help bridge the knowledge gap and equip workers with practical skills.

2. Integration into PHC: Embed oral health services within existing PHC structures to ensure accessibility and sustainability (World Health Organization, 2022) [5]. Mobile dental clinics and community-based interventions can provide essential care to displaced populations.

3. Resource Allocation: Advocate for dedicated funding to support oral health programs in humanitarian settings (FDI World Dental Federation, 2021). Partnerships with international organizations and donors can facilitate resource mobilization.

4. Community Engagement: Educate affected populations about oral health and hygiene practices to promote self-care and prevention (Alemayehu, et al. 2019) [1]. Campaigns tailored to cultural and linguistic contexts can improve community participation and adherence.

5. Policy Advocacy: Work with stakeholders to ensure oral health is recognized as a priority in humanitarian health policies (Ayo-Yusuf & De Wet, 2016) [3]. Establishing oral health indicators in monitoring and evaluation frameworks can further reinforce its importance.

6. Global Strategy Alignment: Align local efforts with the WHO’s Global Strategy on Oral Health to leverage international guidance and resources (World Health Organization, 2022) [5].

The integration of oral health into SPHERE Standards is a necessary step toward comprehensive humanitarian health care. By addressing the oral health needs of vulnerable populations, humanitarian organizations can significantly improve overall health outcomes and quality of life. The inclusion of oral health in SPHERE Standards would reflect a commitment to equity and the holistic well-being of individuals in crisis settings. Implementing these recommendations requires a coordinated effort among policymakers, humanitarian organizations, and community stakeholders. Together, these efforts can pave the way for more inclusive and effective humanitarian health care.

None.

The authors declare no conflict of interest.

1. Alemayehu MA (2019) Impact of water and nutrition on oral health in conflict zones. International Journal of Environmental Health 10(3): 205-212.
2. Al-Khatib IA (2019) Prevalence of dental caries and periodontal diseases in conflict-affected populations. Conflict Health 13(5): 45-51.
3. Ayo Yusuf OA, De Wet FA (2016) Nutrition and oral health: implications for nutrition security in conflict zones. Nutrition Reviews 74(2): 117-123.
4. Borelli ER (2020) Psychological trauma and oral health neglect in displaced populations. Psychological Health and Trauma, 8(4): 312-320.
5. World Health Organization (2022). Global Strategy on Oral Health.