Oral Health in Healthcare

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 26802

Special Issue Editor

1. Melbourne Dental School, University of Melbourne, Carlton, VIC 3053, Australia
2. School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
3. Department of General Practice, University of Melbourne, Melbourne, VIC 3010, Australia
Interests: health service delivery; primary health care; Indigenous health; integrated oral health care; quality care; cultural sensitivity; diabetes; chronic disease
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Special Issue Information

Dear Colleagues,

The importance of needing good oral health and keeping our teeth as we age is well-established and well-known. However, the fact that oral health is intimately related to other parts of our body is less appreciated by the public and, unfortunately, by many non-dental healthcare professionals.

There is evidence that poor oral health can lead to systemic diseases including infections to the rest of the body, diabetes, cardiovascular disease, respiratory disease, dementia and rheumatoid arthritis. It is also well-recognised that this relationship is often bi-directional. For instance, people with periodontitis, where the gums pull away from the teeth and supporting gum tissues and bones are irreversibly destroyed, are more likely to develop diabetes and cardiovascular complications. Recent evidence demonstrates that chronic inflammation of the gums adversely affects blood glucose levels which may require pharmacotherapy management and can lead to diabetes-related complications such as glaucoma and neuropathy. At the same time, people with diabetes have a three-to-four times higher prevalence of severe periodontitis, resulting in premature tooth loss, poor nutrition, suboptimal blood glucose levels, more cardiovascular complications and other morbidity risks.

Professional recommendations and guidelines advocate the need for shared management between medical, dental and allied health practitioners to increase the efficiency of care delivery and improve patient outcomes. The benefits of interprofessional care are even more critical for populations that are vulnerable including culturally and linguistically diverse (CALD) populations, people with disabilities and AOD (alcohol and other drugs) addictions. However, the mouth and the rest of the body continue to be managed separately, particularly in the primary healthcare setting.

This Special Issue of Healthcare seeks commentaries, original research, short reports, and reviews on the role of oral health in the bigger picture of healthcare to bring attention to the relationship between oral and systemic health, and the need for collaboration between oral health and other healthcare practitioners to effectively improve the health and well-being of patients. The aim is to inform the development of health policies, strategies and systems to effect the required paradigm change.

Dr. Phyllis Lau
Guest Editor

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Keywords

  • oral health
  • periodontitis
  • diabetes
  • cardiovascular disease
  • disability
  • drug and alcohol use
  • interprofessional care
  • medical education

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Published Papers (7 papers)

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Research

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11 pages, 259 KiB  
Article
Self-Rated Oral Health as a Valid Measure of Oral Health Status in Adults Living in Rural Australia
by Claudia Atala-Acevedo, Roisin McGrath, Kristen Glenister, Daniel Capurro, Lisa Bourke, David Simmons, Mike Morgan and Rodrigo Mariño
Healthcare 2023, 11(12), 1721; https://doi.org/10.3390/healthcare11121721 - 12 Jun 2023
Cited by 9 | Viewed by 2066
Abstract
It is unclear how well self-rated oral health (SROH) reflects actual oral health status in the rural Australian population. Therefore, this study aimed to compare the clinically assessed oral health status and SROH of adults living in rural Australia. The data were from [...] Read more.
It is unclear how well self-rated oral health (SROH) reflects actual oral health status in the rural Australian population. Therefore, this study aimed to compare the clinically assessed oral health status and SROH of adults living in rural Australia. The data were from 574 participants who took part in the Crossroads II cross-sectional study. Three trained and calibrated dentists evaluated the oral health status of participants based on WHO criteria. SROH was assessed with the question ‘Overall, how would you rate the health of your teeth and gums?’, with a score ranging from excellent = 5 to poor = 1. A logistic regression analysis (LRA) was performed, allowing us to assess factors associated with SROH. The mean age of participants was 59.2 years (SD 16.3), and 55.3% were female. The key results from the LRA show poorer SROH in those with more missing teeth (OR = 1.05; 95% CI; 1.01–1.08), more decayed teeth (OR = 1.28; 95% CI: 1.11–1.46), and more significant clinical attachment loss of periodontal tissue (6mm or more) (OR = 2.63; 95% CI: 1.29–5.38). This study found an association between negative SROH and clinical indicators used to measure poor oral health status, suggesting that self-rated oral health is an indicator of oral health status. When planning dental healthcare programs, self-reported oral health should be considered a proxy measure for oral health status. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
12 pages, 1828 KiB  
Article
The Epidemiology of Dental Pathologies in Elderly Patients Admitted to a Tertiary Level Hospital in Oradea, NW Romania: A 5-Year Retrospective Study
by Michael Janto, Raluca Iurcov, Abel Emanuel Moca, Cristian Marius Daina, Rahela Tabita Moca and Lucia Georgeta Daina
Healthcare 2023, 11(11), 1522; https://doi.org/10.3390/healthcare11111522 - 23 May 2023
Cited by 1 | Viewed by 1558
Abstract
Oral diseases can affect the quality of life of all individuals, including elderly people. In elderly people, the associated general diseases can increase the risk of dental pathologies or can impact their treatment. The main aim of this study was to identify elderly [...] Read more.
Oral diseases can affect the quality of life of all individuals, including elderly people. In elderly people, the associated general diseases can increase the risk of dental pathologies or can impact their treatment. The main aim of this study was to identify elderly patients with dental pathology out of the total number of patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary-level hospital in North-Western Romania. Another aim was to describe the characteristics of the patients included in this study, as well as to analyze data from patients with dental pathologies. In this retrospective study, the medical records of patients admitted to the Department of Oral and Maxillofacial Surgery at the Bihor County Emergency Hospital between 2016 and 2020 were analyzed, with a focus on patients aged 65 years or more. After applying the exclusion criteria, 721 patients were kept in the study, of which 316 (43.8%) had at least one dental pathology. Most elderly patients with dental pathologies were admitted in 2018 (n = 89). The most common associated systemic diseases were arterial hypertension (n = 268) and ischemic heart disease (n = 233), while the most common dental pathologies were pulpitis (n = 185), chronic apical periodontitis (n = 61) and abscesses (n = 35). Most patients were either healed or had an improved condition at the time of discharge. The great number of dental pathologies, as well as the diversity in dental pathologies, underline the necessity for better preventive programs aimed not only at children, adolescents or young people but at the elderly population as well. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
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21 pages, 292 KiB  
Article
Public Awareness of the Association between Periodontal Disease and Systemic Disease
by Fahd Alsalleeh, Abdulmalik S. Alhadlaq, Nora A. Althumiri, Norah AlMousa and Nasser F. BinDhim
Healthcare 2023, 11(1), 88; https://doi.org/10.3390/healthcare11010088 - 28 Dec 2022
Cited by 7 | Viewed by 3540
Abstract
Periodontal disease is associated with other non-communicable diseases including diabetes mellitus, coronary heart disease and atherosclerosis, hypertension, and respiratory tract infections. This association merits careful study of the general population’s awareness level in order to leverage the current state of science to improve [...] Read more.
Periodontal disease is associated with other non-communicable diseases including diabetes mellitus, coronary heart disease and atherosclerosis, hypertension, and respiratory tract infections. This association merits careful study of the general population’s awareness level in order to leverage the current state of science to improve general health and quality of life. This study included 502 residents of Saudi Arabia who received computer-assisted interviews to fill up the survey. Results indicated a low level of awareness among the study population regarding the association of periodontal disease to diabetes mellitus, coronary heart disease and atherosclerosis, hypertension, and respiratory tract infections. A higher level of awareness was noticed with individuals with periodontal disease, themselves or a member of their family having a systemic disease, and who have a specialized person or scientific article as their source of information. This observed low level of awareness deserves the attention of public health authorities to prioritize programs that increase the awareness, improve health, and reduce burden of systemic diseases of high prevalence, morbidity, and mortality. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
16 pages, 1168 KiB  
Article
Diabetes and Oral Health (DiabOH): The Perspectives of Primary Healthcare Providers in the Management of Diabetes and Periodontitis in China and Comparison with Those in Australia
by Andrew Yun, Yuan Luo, Hanny Calache, Yan Wang, Ivan Darby and Phyllis Lau
Healthcare 2022, 10(6), 1032; https://doi.org/10.3390/healthcare10061032 - 2 Jun 2022
Cited by 1 | Viewed by 3280
Abstract
Diabetes and periodontal disease are highly prevalent conditions around the world with a bilateral causative relationship. Research suggests that interprofessional collaboration can improve care delivery and treatment outcomes. However, there continues to be little interprofessional management of these diseases. DiabOH research aims to [...] Read more.
Diabetes and periodontal disease are highly prevalent conditions around the world with a bilateral causative relationship. Research suggests that interprofessional collaboration can improve care delivery and treatment outcomes. However, there continues to be little interprofessional management of these diseases. DiabOH research aims to develop an interprofessional diabetes and oral health care model for primary health care that would be globally applicable. Community medical practitioners (CMPs), community health nurses (CNs), and dentists in Shanghai were recruited to participate in online quantitative surveys. Response data of 76 CMPs, CNs, and dentists was analysed for descriptive statistics and compared with Australian data. Health professionals in China reported that, while screening for diabetes and periodontitis, increasing patient referral and improving interprofessional collaboration would be feasible, these were not within their scope of practice. Oral health screening was rarely conducted by CMPs or CNs, while dentists were not comfortable discussing diabetes with patients. Most participants believed that better collaboration would benefit patients. Chinese professionals concurred that interprofessional collaboration is vital for the improved management of diabetes and periodontitis. These views were similar in Melbourne, except that Shanghai health professionals held increased confidence in managing patients with diabetes and were more welcoming to increased oral health training. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
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Review

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13 pages, 433 KiB  
Review
Referral Compliance Following a Diabetes Screening in a Dental Setting: A Scoping Review
by Andre Priede, Phyllis Lau, Ivan Darby, Mike Morgan and Rodrigo Mariño
Healthcare 2022, 10(10), 2020; https://doi.org/10.3390/healthcare10102020 - 13 Oct 2022
Viewed by 2186
Abstract
With type 2 diabetes prevalence increasing in Australia, and the condition associated with significant morbidity and mortality, screening for dysglycaemia in the dental setting has been proposed to identify asymptomatic individuals. Screening commences with a risk assessment, and individuals identified at elevated risk [...] Read more.
With type 2 diabetes prevalence increasing in Australia, and the condition associated with significant morbidity and mortality, screening for dysglycaemia in the dental setting has been proposed to identify asymptomatic individuals. Screening commences with a risk assessment, and individuals identified at elevated risk for having diabetes are then referred to their medical practitioner for confirmation of their glycemic status. Therefore, for screening to be effective, individuals need to adhere to their oral health professionals’ (OHP) advice and attend their medical follow-ups. This review aims to investigate the literature on referral compliance following a risk assessment in the dental setting and identify barriers and facilitators to screened individuals’ referral compliance. A scoping review of the literature was undertaken, selecting studies of diabetes screening in a dental setting that recorded compliance to referral to follow-up, and explored any barriers and facilitators to adherence. Fourteen studies were selected. The referral compliance varied from 25 % to 90%. Six studies reported barriers and facilitators to attending medical follow-ups. Barriers identified included accessibility, cost, knowledge of the condition, and OHP characteristics. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
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Other

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13 pages, 763 KiB  
Study Protocol
Knowledge, Attitudes, and Practices of Occupational Therapists in Promoting Oral Health: A Protocol for Mixed-Methods Systematic Review
by Ming Nam Tse, Kristy Coxon, Navira Chandio, Shruti Nair, Ajesh George, Rosalind Bye, Grace Wong, Carol Tran, Maria O'Reilly, Kanchana Ekanayake and Amit Arora
Healthcare 2025, 13(4), 416; https://doi.org/10.3390/healthcare13040416 - 14 Feb 2025
Viewed by 767
Abstract
Background/Objectives: Poor oral health is a significant global public health concern that adversely affects an individuals’ overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients’ oral health outcomes. However, [...] Read more.
Background/Objectives: Poor oral health is a significant global public health concern that adversely affects an individuals’ overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients’ oral health outcomes. However, there is limited evidence on the knowledge, attitudes, and practices (KAPs) of occupational therapists regarding oral health, as well as the barriers and facilitators they face in delivering oral healthcare. Methods: This paper outlines a protocol for a mixed-methods systematic review aimed at synthesizing the current evidence on the KAPs of occupational therapists related to oral health, as well as the barriers and facilitators they encounter in promoting it. The upcoming systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. The review will include quantitative, qualitative, and mixed-methods studies that report on KAP, barriers, and facilitators associated with occupational therapists’ involvement in oral healthcare. A comprehensive search will be conducted across multiple databases, including MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS, EMBASE (Ovid), and OTseeker to identify relevant studies. Two reviewers will independently screen the studies for eligibility, assess their methodological quality, and extract key data for synthesis. The protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO (CRD42024522136). Results: The findings from the planned systematic review are expected to provide valuable insights into the role of occupational therapists in promoting oral health, addressing barriers and facilitators, and shaping policies, training programs, and clinical practices. Conclusions: Ultimately, these findings aim to enhance the integration of oral health into occupational therapy and improve client outcomes. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
17 pages, 438 KiB  
Systematic Review
Education/Training Interventions to Improve Oral Health of Adults with Intellectual Disability
by Tejashree Kangutkar, Hanny Calache, Joanne Watson, Susan Taylor and Susan Balandin
Healthcare 2022, 10(10), 2061; https://doi.org/10.3390/healthcare10102061 - 17 Oct 2022
Cited by 6 | Viewed by 3951
Abstract
People with intellectual disability have poorer oral health outcomes and experience greater difficulties accessing dental services than the rest of the community. Interdisciplinary educational programs for those involved in oral health decision making for people with intellectual disability aim to improve their oral [...] Read more.
People with intellectual disability have poorer oral health outcomes and experience greater difficulties accessing dental services than the rest of the community. Interdisciplinary educational programs for those involved in oral health decision making for people with intellectual disability aim to improve their oral health. This scoping review explored education/training interventions related to the oral health of adults with intellectual disability. Interventions targeted dental health and non-dental health professionals, adults with intellectual disability, and their paid and unpaid supporters. Six electronic databases were searched using PRISMA guidelines and the Crowes critical appraisal tool. The search strategy, plus the application of the inclusion and exclusion criteria, presented in the body of the manuscript, led to the selection of 20 papers for inclusion into this review. The quality of undergraduate tuition relating to disability was reported to be poor, but students and dental health professionals expressed interest in expanding their knowledge in this area. Disability-support workers and primary carers of people with intellectual disability reported improved knowledge and attitude, but the oral health status of the people they supported was not impacted. No research was found that explored the perspectives of non-dental health professionals. Oral health training/education contributes to systemic barriers in general health, wellbeing, and social inclusion of people with intellectual disability. Revision of disability-related programs in general dentistry courses and longitudinal impact research is needed. Full article
(This article belongs to the Special Issue Oral Health in Healthcare)
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