ISO CERTIFICATION AND STANDARDISATION SYSTEMS IN DENTAL PUBLIC HEALTH POLICYMAKING AND GOVERNMENT-BASED DENTAL SYSTEMS: A GLOBAL NARRATIVE REVIEW

Background: Oral diseases are the most widespread noncommunicable diseases, and governments are being urged to progress towards universal health coverage for oral health. Quality assurance and standardisation are increasingly discussed as enabling mechanisms, yet the role of International Organization for Standardization (ISO) systems in dental public health policy has not been synthesised. Objective: To review how ISO standards and certification are used in dental public health policymaking and in government-based dental systems globally, and to identify gaps in the evidence. Methods: A narrative review was undertaken using targeted searches of open-access biomedical literature and of official ISO, World Health Organization (WHO) and FDI World Dental Federation sources. Findings were synthesised thematically. Results: ISO influence operates through four domains: (i) product and technical standards developed by ISO/TC 106 Dentistry; (ii) terminology and data standards; (iii) environmental instruments, such as amalgam-separator requirements supporting implementation of the Minamata Convention; and (iv) quality management system certification, principally ISO 9001 and its predecessors, applied to dental facilities and to government health-ministry functions. Evidence on dental facilities is dominated by descriptive reports and recommendations rather than outcome data, is concentrated in high-income settings, and no national dental programme-level evaluation of ISO certification was identified in the sources reviewed. Conclusion: ISO systems are established infrastructure for dental product safety and offer a credible governance tool for process consistency, but their contribution to population oral health outcomes and equity remains unproven. Certification should complement, not replace, outcome-based quality measures, and evaluative research in public-sector and low- and middle-income settings is a priority.