Invisible in the Crisis: Community Narratives on Extreme Weather and Oral Health Inequities in Khyber Pakhtunkhwa, Pakistan

Objective Climate change poses a growing threat to public health, particularly in low- and middle-income countries (LMICs) where fragile systems struggle to cope with extreme weather events. This study explored the lived experiences of communities in Khyber Pakhtunkhwa (KP) Pakistan in accessing dental care during such events over the past five years. Methods A qualitative phenomenological approach was used to examine experiences of individuals affected by floods, heatwaves, and other climate related hazards. A multi stage purposive sampling strategy selected two diverse districts, Swat (north) and Dera Ismail Khan (south). Four gender segregated focus group discussions (FGDs) were conducted in Pashto and Urdu, transcribed, translated into English, and thematically analysed using Braun and Clarke’s six phase framework. Results Participants (n = 24) reported major challenges in accessing dental care during extreme weather events. Four themes emerged: (1) collapse of health services and neglect of dental care (2) compounded financial, physical, and social barriers (3) reliance on indigenous practices and informal networks and (4) exclusion of oral health from disaster preparedness. Vulnerable groups, particularly women, the elderly, and low-income households, were most affected. Conclusion The findings highlight the need to integrate oral health into climate resilience and emergency response strategies. Policy reforms should prioritise mobile dental clinics basic dental training for frontline workers and the inclusion of essential oral health supplies in emergency relief efforts to ensure equitable access during crises.