Background Dental caries, despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern. In Enugu state Nigeria, there is minimal access to adequate and proper oral health care. This study examined the determinants of dental caries treatment provision and the challenges of providing equitable access to oral health care. Method This was a descriptive cross-sectional study conducted in three local government areas in Enugu state Nigeria. The study was conducted using both qualitative and quantitative research methods. The determinants of supply of dental caries treatment services were explored with a focus on provider behaviour, cost of dental services, human resource availability and availability of dental equipment. Results Five factors determine what dental caries treatment service is provided viz: cost of raw materials (100%), human resources (98.1%), geographical location (98.1), Government policies (88%) and price of other goods (80.8%). Inadequate awareness and knowledge, high cost of treatment services, inadequately skilled staff, poor government funding and policy for oral health, limited primary healthcare facilities offering dental treatment services and poor knowledge of dental caries treatment options are factors that determine dental service provision and equally influence access to oral health care. There are still a limited number of dental facilities in the country with a growing need for dental caries treatment/services and other dental issues. Conclusion Adequate access to oral health care services is a major concern that affects all aspects of healthcare and a determining factor in the country’s drive to achieve universal health coverage. In order to address this, there is a need to incorporate oral health into the general health care system. Dental health facilities need to be strategically located and properly equipped with materials, equipment and adequate skilled staff.
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