Oral health practices and health-seeking behaviors among adults in ghana: findings from a nationwide WHO STEPS survey

Oral health is a key determinant of overall well-being, yet it remains under-prioritized in public health efforts across low- and middle-income countries, including Ghana. Despite evidence of increasing oral disease burden, the country lacks recent nationally representative data to inform oral health policy and interventions. This study assessed oral health practices and health-seeking behaviours among Ghanaian adults using data from the 2023 WHO STEPS survey. A population-based cross-sectional survey was conducted in all 16 regions of Ghana from June and August 2023. A total of 5,438 adults aged 18–69 years were selected using multistage cluster sampling. Data were collected through face-to-face interviews using an adapted WHO STEPS questionnaire that included oral health indicators. Data were weighted to ensure national representativeness and analysed using STATA version 15. Weighted proportions with 95% confidence intervals were estimated and disaggregated by age, sex, and residence. A high proportion of adults (98.9%) had ≥ 20 natural teeth. However, 29.0% experienced oral pain or discomfort in the past year, while only 3.4% had visited a dentist and 84.9% had never received dental care. Although 98.2% cleaned their teeth at least once daily and 94.1% used toothpaste, only 54.3% brushed twice daily. Traditional oral hygiene tools—such as chewsticks (57.5%) and charcoal (14.2%)—were commonly used alongside toothbrushes (93.3%). The coexistence of high tooth retention and very low dental care utilization highlights an important oral health paradox in Ghana. While basic and traditional hygiene practices appear to support tooth retention, unmet oral health needs remain high, particularly for oral pain. Strengthening preventive services, integrating oral health into primary care, expanding coverage within Ghana’s universal health coverage framework, and promoting consistent use of fluoride toothpaste are essential for improving population oral health.