Community health worker-supported oral health promotion in low- and middle-income countries: a scoping review of roles, interventions, and outcomes

Background Oral diseases are among the most prevalent conditions worldwide and disproportionately affect populations in low- and middle-income countries (LMICs). The shortage and maldistribution of the oral health workforce have widened inequalities in prevention and treatment. Task-sharing through community health workers (CHWs) has been promoted as a cost-effective and sustainable strategy for extending services to underserved populations; however, evidence on their roles in oral health promotion in LMICs remains fragmented. This scoping review mapped evidence on CHW-supported oral health promotion and identified common roles, interventions, and system-level challenges.
Methods A comprehensive search was conducted in PubMed, CINAHL, CENTRAL, and Google Scholar, using keywords and MeSH terms related to “community health workers,” “oral health,” and LMICs, based on the EPOC LMIC filter of the World Bank’s classifications. No publication date restrictions were applied, and gray literature was included. The review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Data were charted on CHW characteristics, roles, target populations, oral conditions addressed, and implementation challenges, and synthesized narratively. This protocol was registered on Open Science Forum (https://doi.org/10.17605/OSF.IO/NZPHA).
Results Thirty-two studies from 11 LMICs were included, approximately half from India. The evidence mapped a wide range of CHW roles and interventions, most commonly focusing on oral cancer screening, followed by dental caries prevention and periodontal care. CHWs were involved in home visits, education, screening, basic treatment, and referrals. Some programs integrate mobile health (mHealth) tools for remote diagnosis. System-level challenges were variably reported across settings, including inadequate infrastructure, fragmented referral systems, limited supervision, and constrained career development opportunities for CHWs.
Conclusions This scoping review highlights the contributions of CHWs to oral health promotion in LMICs, while underscoring health system and workforce constraints. The available evidence is largely descriptive, suggesting the need for strengthened training, supervision, referral linkages, and career development to support CHWs’ integration into oral health services. Family-centered and Continuum of Care approaches warrant further exploration to inform equitable and sustainable oral health within primary health care systems.