Spatial Distribution of Community Oral Healthcare Resources and Their Association with Oral Health Status in Shanghai, China

Background This study aimed to assess the distribution and equity of community oral healthcare resources in Shanghai and to examine their associations with population-level oral health indicators, including dental caries prevalence and periodontal health rate. Methods Data were collected from 249 community health service centers across 16 administrative districts in Shanghai, China, encompassing human resources, equipment allocation, and the implementation of public oral health programs. Additionally, clinical oral health data were obtained from sampled residents in selected districts. The equity of resource distribution was evaluated using Gini coefficients, Lorenz curves, and Theil indices. Pearson correlation analysis was conducted to explore the associations between resource indicators and oral health outcomes. Results A total of 249 community health service centers, located across 16 districts in Shanghai, were surveyed. The dental public health workforce was predominantly female (78.2%) and relatively young, with 63.9% of the workforce aged 44 or younger. While 76.6% held a bachelor’s degree or higher, only 4.2% had senior professional titles. Suburban districts held 66.02% of registered dental chairs and 57.68% of clinic space. Also, they had higher counts of both basic equipment (e.g., dental chairs, ultrasonic scalers) and high-end devices such as implant systems, microscopes, and laser therapy units (see Table 3). The Gini coefficients for independent dental departments were 0.151 by geography, 0.357 by population, and 0.362 by economic output. For dental chairs, the corresponding values were 0.356, 0.420, and 0.400. The Theil index for the geographic distribution of dental chairs was 0.7128; suburban and urban values were 0.3809 and 0.0359, respectively. Suburban areas contributed 92.66% to the overall geographic inequality, while urban areas contributed 7.34%. The correlation between the Dental Manpower Index and periodontal health rate was 0.881 (p = 0.020); for the dentist-to-population ratio, the correlation was 0.870 (p = 0.024). Conclusions Notable spatial disparities exist in the allocation of community oral healthcare resources in Shanghai, which may influence population oral health outcomes. Policy adjustments are recommended to enhance high-quality resource coverage in underserved areas and strengthen primary care capacity, thereby promoting oral health equity and efficiency.