Oral Health and Oral Health Inequities in Kalaallit Nunaat (Greenland)

AIM: Oral health in Kalaallit Nunaat (Greenland) is characterized by a high burden of dental disease and inequities, despite long-standing public provision of dental care and targeted prevention strategies. The aim of this commentary is to give direction on how to improve oral health in Kalaallit Nunaat by describing the oral health situation and examining the determinants underpinning the poor oral health and inequities in oral health. RESULTS: Archaeological and early epidemiological data show that caries was virtually absent among Inuit populations prior to the mid-20th century, followed by a rapid and substantial increase associated with dietary transition, societal change, and altered living conditions. A national caries strategy was introduced in 2008 resulting in an initial improvement in the caries situation. This was followed by stagnation in the improvement, and at present, the caries prevalence in children and adolescents is high in Kalaallit Nunaat. Further, marked disparities in caries prevalence between towns and smaller communities exist, with especially high prevalence in smaller communities. Evidence on adult oral health remains scarce, and surveillance largely focuses on dental caries, thereby limiting insight into life-course patterns, non-caries conditions, and patient-reported outcomes. Structural challenges, including geographic remoteness, workforce instability, limited fluoride exposure, and constrained preventive capacity, seem to undermine equitable oral health outcomes. CONCLUSIONS: The findings indicate that prevention-focused dental services alone are insufficient to overcome entrenched structural inequities. Sustainable improvements in oral health equity in Kalaallit Nunaat require strengthened population surveillance, culturally safe and co-created interventions, workforce stabilization, and coordinated upstream actions addressing diet, social conditions, and broader public health determinants.