Bridging Aspirations and Reality: Challenges in Oral Health Policy Implementation in Karnataka, India

This study examines gaps in the formulation and implementation of oral health policy in Karnataka, India, where equitable access to services remains a challenge despite multiple initiatives. Using an exploratory qualitative design, the research applied backward mapping and policy landscaping to eight policy documents from 2000 to 2025. Content analysis assessed how oral health issues were framed, while stakeholder perspectives were gathered from 31 participants, including policymakers, administrators, and dental professionals, through interviews and focus group discussions.Findings reveal that oral health policies are often inconsistent and lack actionable details, dedicated funding, and integration into broader health systems. Stakeholders highlighted systemic neglect, marked by chronic underfunding, workforce shortages, and limited awareness of existing policies. Weak accountability mechanisms and the absence of robust monitoring and evaluation frameworks further hinder effective implementation. Importantly, administrators, the key actors in implementation, were frequently excluded from policymaking processes, leading to limited ownership and reduced policy effectiveness.The study concludes that although oral health has gained increasing policy attention, implementation remains fragmented. Addressing these challenges requires structural reforms, including dedicated budgets, strengthened workforce capacity, and improved monitoring systems to ensure equitable and effective oral health service delivery, particularly for underserved populations.