Around 80% of African communities can be considered to be materially deprived. The presence of widespread poverty and underdevelopment in Africa means that communities are increasingly exposed to all of the major environmental determinants of oral disease. Previous approaches to oral health in Africa have failed to recognize the epidemiological priorities of the region or identify reliable and appropriate strategies to address them. Efforts have consisted of providing unplanned, ad hoc and spasmodic curative oral health services, which in most cases are poorly distributed and only reach affluent or urban communities. Realizing the limited impact of existing strategies, the World Health Organization Regional Office for Africa (WHO/AFRO) developed a regional oral health strategy to assist African countries and their partners in identifying priorities and planning preventive-oriented programmes, particularly at the district level. The long-term objective is to provide equitable and universal access to cost-effective quality oral healthcare and thereby significantly reduce the incidence of oral diseases in Africa.