Oral diseases comprise a major portion of non-communicable diseases (NCDs), affecting an estimated 3.7 billion people.1,2 This number should be underscored as it is 1 billion higher than the number for diabetes mellitus, cardiovascular disease, cancers, chronic respiratory disease, and mental and neurological disorders combined.1 Oral diseases affect vulnerable and underserved populations who have limited accessibility to oral health care.1 Thus, oral diseases are a global burden and represent significant health inequity.

To foster better oral care, various strategic plans have been devised: the Resolution on Oral Health (2021), the Global Strategy on Oral Health (2022) and the Global Oral Health Action Plan (2023-2030). These action plans show the need to include oral diseases under NCD agenda and Universal Health Care package benefits.2,3 Many attempts have been made to emphasise the need for oral care, but it still remains overshadowed by other NCDs. This neglect becomes visibly apparent with the current omission of oral diseases in the Zero Draft of the political declaration of the upcoming 4th United Nations High-Level Meeting (HLM4) on Non-Communicable Diseases (NCDs).

The omission of oral health from a UN draft raises serious concerns of commitment and execution at the policy level. To the workforce who have contributed their entire life to the field of oral health, the situation is, at the same time, disheartening and appalling, especially when oral diseases share risk factors and bidirectional relationships with other systemic NCDs and often cluster with them.4 While some may define it as intangible discrimination, others may find it to be a failing at the policy making level. And the result is quite clear: no roadmap; no plan; no action; no execution.

Recommendations and urgent requests have been made by different federations to feature oral health in HLM4, which will take place on 25 September 2025 in New York. The integration of oral health in HLM4 and other health strategies is of utmost significance to all governments, policy makers, advocates and stakeholders in order to achieve the goal of oral health governance. There is a dire need to justify the Bangkok Declaration - ‘No Health Without Oral Health', starting from the policy level.