Role of Anganwadi workers in community-based oral health promotion in India: a scoping review

Anganwadi workers (AWWs), grassroots-level healthcare workers, play a central role in India’s Integrated Child Development Services (ICDS) and are well-positioned to support community-based oral health promotion. However, oral health remains insufficiently integrated within routine ICDS activities, and evidence regarding the role of AWWs in oral health promotion is dispersed across diverse study designs and settings. This scoping review aimed to map the available evidence on the role of AWWs in oral health promotion in India. This scoping review followed Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A Population–Concept–Context framework was used to define the eligibility criteria. PubMed, Scopus, CENTRAL, and Google Scholar were searched up to December 2025. Quantitative, qualitative, mixed-methods, and relevant review studies conducted in India were eligible. Data were charted on study characteristics, AWWs’ oral health knowledge, attitudes, and practices, training and educational interventions, child- and caregiver-level outcomes, and implementation-related factors. Evidence was synthesised descriptively and thematically and mapped to the three review questions according to the content addressed by each study. A total of 46 studies were included (18 cross-sectional, 24 interventional, 1 qualitative, and 3 reviews) from 310 records. The evidence indicated variability in AWWs’ oral health knowledge and practices, with persistent limitations in preventive oral health topics (fluoride, early childhood caries (ECC) risks, infant and preschool oral hygiene). Interventional studies suggested that structured oral health training could improve AWWs’ knowledge and capacity to deliver preventive oral health messages, with some studies reporting improvements in caregiver awareness and children’s oral hygiene-related behaviours. Implementation-related findings highlighted community trust and willingness to participate in training as potential facilitators, while workload, limited reinforcement and supervision, and restricted access or linkages to dental services were identified as barriers. The evidence base was heterogeneous and predominantly short-term, with limited evidence regarding long-term sustainability, scalability, and routine integration of oral health activities within ICDS. AWWs may provide an opportunity to extend preventive oral health promotion through established community-based maternal and child health platforms. Structured and practical training, periodic reinforcement, supportive supervision, feasible workload expectations, and appropriate linkages with dental services may support their sustained contribution to oral health promotion. However, evidence on long-term sustainability, scalability, and routine integration within ICDS remains limited. Future research should prioritise longer-term, implementation-focused evaluations across diverse Indian settings.