Toward Equity in Oral Health: Thailand's 15-Year System-Level Initiative for People with Disabilities (2011 to 2025).

Background: People with disabilities experience disproportionate oral health burdens worldwide. In Thailand, despite universal health coverage (UHC), persistent barriers-including transportation, caregiver availability, distance, and costs-limit access to care. Since 2011, government and partners have pursued multilevel actions to improve equity for this population, yet no comprehensive synthesis of their evolution has been reported. Objective: To describe the context and content of Thailand's 2011 to 2025 initiative for people with disabilities, summarize what was implemented across policy, workforce, curriculum, services, and governance, and identify observed results, limitations, and next steps for sustainability. Methods: A national secondary synthesis aligned with SQUIRE 2.0 analyzed policy documents, program reports, and training materials (2011 to 2025) using document and thematic analyses with contribution analysis and triangulation. Eligibility required relevance to disability-inclusive oral health in Thailand; units were policies, curricula, service models, and financing/monitoring, and engagement mechanisms were extracted as reported; no human data were used, and ethics approval was not required. Results: The initiative advanced through four overlapping phases: Phase 1 (2011 to 2014) comprised Thai Health Promotion Foundation (ThaiHealth) funded pilot projects to increase access, followed by increasingly explicit government policy in Phase 2 (curriculum integration and professional development, 2015 to 2017), Phase 3 (network expansion and digital knowledge sharing, 2017 to 2020), and Phase 4 (institutionalization and policy integration, 2021 to 2025). Actions were associated with expansion of dental service sites from 11 to 30 across 12 provinces, integration of special care dentistry into multiple dental curricula, establishment of specialty boards, and adoption of national strategic frameworks. Persistent barriers included workforce shortages, transportation difficulties, and gaps in national oral health data. Conclusion: Thailand's phased, system-level strategy demonstrates how policy integration, curriculum reform, and network development can accelerate equity in oral health care for people with disabilities. Priorities for sustainability include a nationwide disability-focused oral health survey, rural workforce pipelines, integration of special care dentistry into UHC benefits, and expanded use of digital platforms. Lessons may inform similar reforms in other middle-income settings.