People in developing countries are burdened excessively by oral diseases, particularly periodontal disease. These are aggravated by poverty, poor living conditions, ignorance concerning health education, and lack of government funding and policy to provide sufficient oral health care workers. WHO and FDI have identified the problems and developed strategies. However, acceptable goals and standards of oral health have to be agreed. Furthermore, barriers to oral health promotion need to be overcome through co-operation at all levels and appreciation of cultural sensitivity. There is the need for research to determine which types of oral health care systems are most effective in reducing the extent of inequality in oral health. In developing countries where there are huge problems, intervention programmes focusing on primary care and prevention should be designed and implemented urgently and their effectiveness monitored and analysed scientifically. The WHO, FDI and national and international professional organisations should play a leading role in encouraging a determined, co-ordinated effort towards improving the oral health status of disadvantaged people in developing countries.