Ketema, BetelehemLansdown, KarenAl Naasan, ZeinaHan, HeuiwonTrafford, Julie2026-03-182026-03-182026-02-11BMC Oral Health, ISSN: 1472-6831 (Print); 1472-6831 (Online), BMC, 26, 1-16. doi: 10.1186/s12903-026-07801-01472-68311472-6831http://hdl.handle.net/10292/20787Background: Despite the growing need for culturally valid oral health tools in refugee populations, no validated Amharic-language versions of key instruments currently exist. This review synthesises how the OHIP-14 and WHO Oral Health Assessment tools have been adapted across linguistic and cultural contexts, with implications for Amharic-speaking Ethiopian refugees. Aim: To assess how OHIP-14 and WHO-OHAFT have been cross-culturally adapted and validated globally, and to identify gaps and equity implications for developing Amharic-language tools in refugee contexts. Methods: We conducted a hybrid systematic–narrative review of 21 studies, using structured database and grey-literature searches followed by descriptive mapping and thematic synthesis. Studies were charted by language, adaptation procedures, and psychometric properties (e.g., Cronbach’s α, intraclass correlation coefficients). Cross-cultural adaptation frameworks, such as those of Beaton et al. and WHO translation guidelines, guided the assessment of methodological and linguistic rigour across studies. Results: Three main themes emerged: [1] consistent psychometric strength across diverse cultural adaptations; [2] methodological variation and reporting gaps in cross-cultural validation; and [3] a complete absence of validated Amharic-language tools. While Cronbach’s α values ranged from 0.72 to 0.99 (mean = 0.88), many studies omitted essential adaptation steps. Refugee-specific oral health beliefs, such as spiritual interpretations of pain, are rarely integrated. Conclusion: This review highlights both strong potential and critical limitations in current cross-cultural oral health assessments. It emphasises the ethical and clinical needs for developing validated, culturally appropriate Amharic tools. Cross-cultural adaptation should be seen as a step towards linguistic justice and oral health equity for Amharic-speaking refugee and displaced populations.Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Amharic languageCross-cultural adaptationOHIP-14Oral health–related quality of lifePsychometric validationRefugee oral health32 Biomedical and Clinical Sciences3203 DentistryHealth DisparitiesSocial Determinants of HealthBehavioral and Social ScienceHealth Disparities and Racial or Ethnic Minority Health ResearchDental/Oral and Craniofacial DiseaseBasic Behavioral and Social Science1105 DentistryDentistryJournal ArticleOpenAccess10.1186/s12903-026-07801-0