Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: Protocol for a scoping review

Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: Protocol for a scoping review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: Protocol for a scoping review Amitha Basheer N, Praveen Jodalli, Shishir Ram Shetty, Ramya Shenoy, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4961741/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 18 Mar, 2026 Read the published version in Systematic Reviews → Version 1 posted 4 You are reading this latest preprint version Abstract Background Oral health is a significant indicator of overall wellness and health, although it is often ignored in general healthcare. Despite the development of various oral health assessment (OHA) tools for non-dental health professionals (NDHP), there is limited comprehensive understanding of their scope, and application, This scoping review will systematically explore the available research on OHA tools used by non-dental healthcare providers, focusing on their development, psychometric properties, and utilization across different settings. Methods Arksey and O'Malley framework will direct this review and will be reported in line with the PRISMA-ScR guidelines. A comprehensive search strategy has been developed and preliminary search was conducted in three major databases: PubMed, Scopus, and Web of Science. The search will include studies from inception to June 30, 2025. Studies will be selected based on predefined inclusion and exclusion criteria. Data charting will be done using a charting form and analysed through narrative synthesis. Results The review will provide a detailed mapping of the OHA tools currently available for non-dental healthcare providers, including their psychometric properties, settings of use, and the populations they target. The analysis will identify gaps in the literature and highlight the tools that are most effective in promoting early detection and management of oral health issues by NDHP. Conclusion This scoping study will provide a detailed overview of the oral health screening tools available to non-dental healthcare professionals, shedding light on their utility, and areas requiring further research. Oral health assessment Non-dental healthcare professionals Psychometric properties Oral health tools Integrated healthcare Holistic care Scoping review INTRODUCTION Oral health is a crucial indicator of general health, well-being, and quality of life, with a close and complex relationship to systemic outcomes¹. Oral conditions are among the most common noncommunicable diseases; about 45% of the world’s population experience them across the life course². As a determinant of overall health, oral health influences daily functioning and general health outcomes³. Poor oral health leads to dental caries, periodontal diseases, and oral infections that affect oral structures and can have systemic consequences³. Regular oral health assessments (OHA) are necessary to monitor changes in oral health status and evolving needs⁴. Such assessments help identify areas for improvement in clinical practice and address deficiencies in oral health knowledge and behavior⁵. The strong bidirectional relationship between oral and general health highlights the importance of integrating oral health into healthcare practice⁶. Despite its significance, oral health is often neglected in healthcare delivery. At many health settings, oral health components are overlooked, hindering the implementation of integrated care⁷. Dentistry has historically been isolated from mainstream health systems, with much care delivered by private practitioners rather than within public health frameworks. As a result, oral health has frequently been viewed as a marginal issue of low priority². NDHP including physicians, nurses, and allied health workers, form an intrinsic part of the health system⁸. Through their interactions with patients across a wide range of medical conditions, they are strategically positioned to promote oral health as part of comprehensive patient care⁸. Over the past two decades, several OHA tools have been developed for NDHP to facilitate early identification, monitoring, and referral of oral problems⁹. Research has shown that embedding OHA and health-promotion competencies into continuing education for NDHP enhances the delivery of oral healthcare⁶. These tools enable NDHP to support early detection, prevention, and management of oral conditions, thereby improving outcomes¹⁰. Continuous development and validation of such tools are essential to address psychometric gaps and ensure comprehensive coverage of OHA domains¹¹. Use of these tools by NDHP is crucial for preventing oral diseases, promoting oral health, and ensuring timely referral to dental care¹². Indigenous and community health workers have also been shown to play an important role in contexts such as promoting oral health in pregnancy, emphasizing the need for tailored interventions for different populations¹². Accordingly, policy measures, training programs, and collaborative care models have been proposed to expand the role of non-dental primary care providers in delivering OHA, particularly general practitioners and nurses¹³. Standardized instruments, such as the Oral Health Assessment Tool (OHAT), have been advocated to support screening, triage, and referral¹⁴. Equipping healthcare providers with adequate knowledge and skills helps overcome systemic barriers to health and well-being, particularly in vulnerable groups¹⁵. The development and validation of OHA instruments for NDHP remain important to improve the quality of care and outcomes, especially for vulnerable populations⁶. Collaborative, transdisciplinary approaches between dental and medical professionals have shown effectiveness in assessing and managing oral health, particularly for patients with complex medical conditions¹¹. Extending the responsibilities of NDHP in this area is a promising strategy to enhance both oral and general health outcomes¹⁶. Integrating oral health into primary care is therefore essential to address gaps in OHA and management by NDHP¹⁷. Such integration supports holistic healthcare delivery, improves accessibility and affordability of oral care²,¹⁰, and strengthens population health outcomes. With appropriate tools, targeted training, and collaboration with dental professionals, NDHP can significantly contribute to oral health promotion and early management across diverse settings. Given this background, the present review aims to systematically identify and map the oral health assessment tools developed for use by NDHP across diverse care settings, while evaluating their scope, application, and psychometric properties. METHODS A scoping review is the better approach in assessing OHA tools for NDHP considering the comprehensiveness and exploratory nature associated with it, besides its capacity for comprehensive mapping of available literature. In this way, a scoping review enables broad examination of the available literature, including several designs, methodologies, and sources in mapping out available evidence on this topic. 18 It shall provide good scrutiny on the subject area under study to give insights into different tools, psychometric properties, and applications, and their impact on oral health. The current review will follow the reporting standards specified in the scoping review extension PRISMA-ScR 19 . The approach will adhere to the five stages established in Arksey and O'Malley's methodological framework, which offers a comprehensive conceptual scope appropriate for capturing a diverse variety of relevant research 20 . Using this methodology, the scoping review will thoroughly map the available literature on OHA tools used by NDHP. This protocol is prospectively registered in Open Science Framework (OSF) registration platform 21 Stage 1: Identifying the research question PCC (Population Concept Context) framework was used to frame the research question 22 . PCC elements and its descriptions are provided in Table1. Table 1: PCC framework PCC elements Description Population Non-dental healthcare professionals involved in oral health assessment (e.g., physicians, nurses, allied health workers). Concept Oral health assessment tools designed for use by non-dental healthcare professionals, including those developed or validated. The review will consider tools with available information on their scope, application, and psychometric properties. Context Any clinical, community, or rehabilitation setting, irrespective of geographic location, where such oral health assessment tools have been utilized, tested, or validated. Research questions: What oral health assessment tools are available for use by NDHP, and in which settings (clinical, community, or rehabilitation) have they been utilized, tested, or validated.? What evidence exists regarding the scope, application, and psychometric properties of these tools? Stage 2: Identifying relevant studies This stage involves developing a search strategy plan, involving decisions regarding search resources, keywords, publishing time frame, and language. Search sources A comprehensive search strategy was developed, incorporating specific keywords related to OHA tools and NDHP. A preliminary search was performed in three databases: PubMed, Scopus, and Web of Science, to identify relevant articles on OHA tools for NDHP. Proposed search terms and their synonyms with preliminary search results are presented in supplementary material 1. Keywords/MeSH terms and their alternate terms were used in combination with Boolean operators ‘OR’ and ‘AND’ to retrieve relevant studies. A PRESS (Peer Review of Electronic Search Strategies) checklist will be used to assess the quality of search strategies to ensure that search strategies are comprehensive, transparent, and replicable, thereby minimizing the risk of bias in the review process 23 . In addition, the reference lists of all selected studies will be manually reviewed to identify other relevant papers. Eligibility criteria Inclusion criteria Peer-reviewed primary studies Studies published in English from inception to June 30, 2025. Studies involving non-dental healthcare professionals such physicians, nurses, allied health workers, community health workers, caregivers. Studies reporting on the development, testing, validation, or utilization of oral health assessment tools in any setting clinical, community, rehabilitation). Studies that describe tool characteristics, with or without psychometric evaluation (e.g., reliability, validity). Exclusion criteria Studies that focus exclusively on dental professionals as users of OHA tools. Secondary literature (systematic reviews, scoping reviews, meta-analyses, narrative reviews), editorials, commentaries, conference abstracts, and other grey literature. Non-English publications. Articles without accessible full text, after attempting to contact corresponding authors. Studies that do not evaluate or describe an OHA tool or those addressing only oral health knowledge, attitudes, or general outcomes without an assessment instrument. Gray literature will not be included in this review. The decision was made to ensure that only peer-reviewed, methodologically rigorous studies are analyzed, thereby enhancing the reliability and reproducibility of findings. While gray literature may provide additional information, it often lacks adequate methodological detail and peer-review verification, which may introduce bias or compromise quality. For studies where only abstracts are available, attempts will be made to obtain the full text by contacting the corresponding authors. Only if the full text remains inaccessible after these efforts will the study be excluded. Stage 3: Selection of studies All references that are the result of the comprehensive search strategy will initially be exported into Rayyan software 24 . This will allow managing these references to have an organized workflow. As imported, Rayyan will automatically indicate and highlight the potential duplicate references. These duplicates will have to be manually reviewed and confirmed before removal to ensure that no relevant studies are missed out. The next step involves a thorough screening of the titles and abstracts of the remaining references. Two reviewers will do this independently to avoid bias and increase reliability in the selection process. The reviewers will assess each study against the predefined inclusion and exclusion criteria to determine its relevance to the scoping review. Any irrelevant studies will be eliminated at this stage. Full-text articles of the studies passed by this initial screening will be obtained for a more in-depth review. The full texts will then be retrieved and screened independently by two reviewers. In this phase, the reviewers will look for details about the type of study design, characteristics of the population involved, the tool, and its psychometric properties. In case there is some discrepancy between the two reviewers on any study with respect to its inclusion or exclusion, such discrepancies shall be resolved through discussions. If the need for consensus by the two reviewers is still not reached, then consultation with a third reviewer will ensue. The third reviewer will, in turn, review that study independently; his/her decision shall be final. This process ensures that the selection of studies is fair and unbiased. The whole process of selection will be documented, and it will include the reasons for excluding studies. The PRISMA flow diagram describes the flow of studies through the selection process 25 . This will contain the total number of studies identified, screened, and eligible, and included in the review, the number excluded at each stage, and the reason for exclusion. Stage 4: Charting the data After the studies are selected, data extraction from the studies will be done and entered in Microsoft Excel 26 . A priori, a standardised data charting form will utilize in this review, which will capture all the relevant data from studies. It will capture information such as author(s), year of publication, title, country, health setting, study design, setting, population characteristics (age, gender, profession), sample size, psychometric properties: validity and reliability, outcomes, and key findings of studies (supplementary file 2). To increase homogeneity in data extraction, two reviewers will do it independently with a third reviewer to resolve the discrepancies. In the process, a detailed log will be maintained of any decisions taken during data extraction. Deviations from the original strategy will be documented in the review's methodology section. Pilot testing of the data charting form The data charting form will be pilot-tested on a sample of 5 studies that meet the eligibility criteria. Two independent reviewers will extract data from this subset to evaluate whether the form captures all relevant information consistently and reliably. Discrepancies between reviewers will be discussed and resolved with the involvement of a third reviewer if necessary. Based on the outcomes of this pilot, the data charting form will be refined to improve clarity, consistency, and comprehensiveness before being applied to the full set of included studies. Any modifications made during this process will be documented in the protocol and reported in the final review. Stage 5: Collating, Summarizing and Reporting Results Summary tables will be produced providing an overview of the key characteristics of included studies. It will help identify patterns across studies, including gaps in the literature. A descriptive summary of the included studies will be given. This comprises a narrative account of the number of studies, their distribution by type, geographical location, populations studied, and other relevant characteristics. A descriptive narrative synthesis will be done, with a view to answering the research questions, providing insight into the overall evidence base. In addition to the narrative synthesis, data would be represented using tables, or maps of trends or gaps in research. Where appropriate, subgroupings such as healthcare professional type or care setting will be done to provide additional insights. Status of the study The protocol is currently registered on the Open Science Framework registration portal. https://doi.org/10.17605/OSF.IO/EX7M6 , and an initial search has been conducted. The title, abstracts, and index terms of the papers retrieved have been examined for keywords and search terms relevant to the study. Dissemination of data The data collected or the results from the review will be disseminated through academic journals, conferences, and institutional repositories so that the findings will reach and benefit the targeted community, researchers, practitioners, and policymakers. Conclusion This scoping review process has been established for the careful analysis and mapping of the landscape associated with OHA tools used by NDHP across various contexts. The review will identify literature gaps in the scope, structure, and psychometric properties of these tools and to provide an overview of available evidence through a detailed examination of the same. The findings will be used to guide the development and enhancement of assessment practices in oral health by non-dental health care providers about holistic and integrated health care delivery. Abbreviations NDHP: Non-dental health professionals OHA: Oral health assessment OHAT: Oral health assessment tool OSF: Open Science Framework PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Declarations Ethical Approval and Consent to participate This study will include secondary data from published articles; therefore it does not need ethical approval and consent. Consent for publication Not applicable Availability of data and materials No data associated with this article. Competing interests No competing interests declared. Funding No funding has been received for this study Authors' contributions All authors contributed to the study conception and design. ABN and PJ performed acquisition of data, drafted the article, review and editing of draft, revision of the article and final approval of the version. SSR, RS,AR,MP,ABR performed drafting of article and review and editing of draft. All authors read and approved the final manuscript. Acknowledgements Not applicable References Basheer N A, Jodalli P, Ram Shetty S, Shenoy R, Rao A, Pai M, B R A, Nayak N. (2024). Development and Validation of “Basic Oral Health Assessment Tool” (BOHAT) for Non-Dental Healthcare Professionals for Indian Adult Population: A Mixed Method Research JMIR Preprints. 21/06/2024:63480. https://doi.org/10.2196/preprints.63480‌ World Health Organization (2022). The Global Status Report on Oral Health 2022. [online] Available at: https://www.who.int/team/noncommunicable-diseases/global-status-report-on-oral-health-2022. Nemati, S., Ghasempour, M., & Khafri, S. (2016). Impact of oral and dental health on quality of life in Iranian preschool children and their families. Electronic Physician, 8(11), 3296-3301. https://doi.org/10.19082/3296 Brega, A. G., Johnson, R. L., Jiang, L., Wilson, A., Schmiege, S. J., & Albino, J. (2021). Influence of parental health literacy on change over time in the oral health of American Indian children. International Journal of Environmental Research and Public Health, 18(11), 5633. https://doi.org/10.3390/ijerph18115633 Rodrigues, A., Hegde, V., Hegde, A., Shastri, S., Ravikumar, D., & Rodrigues, R. (2021). An exploration of the oral health beliefs and behaviours of people living with HIV in Mangalore, India: a qualitative study. BMC Oral Health, 21(1). https://doi.org/10.1186/s12903-021-01549-5 Kossioni, A., Hajto‐Bryk, J., Maggi, S., McKenna, G., Petrovic, M., Roller‐Wirnsberger, R., & Müller, F. (2017). An expert opinion from the European college of gerontology and the European geriatric medicine society: European policy recommendations on oral health in older adults. Journal of the American Geriatrics Society, 66(3), 609-613. https://doi.org/10.1111/jgs.15191 Duangthip, D., & Chu, C. H. (2020). Challenges in Oral Hygiene and Oral Health Policy. Frontiers in oral health , 1 , 575428. https://doi.org/10.3389/froh.2020.575428 Sabbahi, D. (2023). The effectiveness of oral health education among non-dental healthcare professionals in Jeddah, Saudi Arabia: a quasi-experimental study. Cureus. https://doi.org/10.7759/cureus.49187 Thapa, R., Chimoriya, R., & Arora, A. (2021). The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-020-01989-8 Everaars, B., Weening-Verbree, L., Jerković-Ćosić, K., Schoonmade, L. J., Bleijenberg, N., Wit, N. J. d., ..& Heijden, G. J. M. G. v. d. (2020). Measurement properties of oral health assessments for non-dental healthcare professionals in older people: a systematic review. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-019-1349-y Obana, M., Furuya, J., Matsubara, C., Tohara, H., Inaji, M., Miki, K., … & Maehara, T. (2019). Effect of a collaborative transdisciplinary team approach on oral health status in acute stroke patients. Journal of Oral Rehabilitation, 46(12), 1170-1176. https://doi.org/10.1111/joor.12855 Villarosa, A. C., Villarosa, A. R., Salamonson, Y., Ramjan, L. M., Sousa, M. S., Srinivas, R., … & George, A. (2018). The role of indigenous health workers in promoting oral health during pregnancy: a scoping review. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5281-4 Ono, K., Hironaka, S., Utsumi, A., Yamaguchi, A., Shibata, Y., Osakabe, L., … & Maruoka, Y. (2024). Effective oral indicators with medical and dental collaboration in open heart surgery: a representative survey. Cureus. https://doi.org/10.7759/cureus.62392 Suzuki, H., Furuya, J., Nakagawa, K., Hidaka, R., Nakane, A., Yoshimi, K., … & Minakuchi, S. (2023). Factors influencing the selection of oral healthcare providers in multidisciplinary nutrition support team for malnourished inpatients: a cross‐sectional study. Journal of Oral Rehabilitation, 50(12), 1446-1455. https://doi.org/10.1111/joor.13565 Poudel, P., Paudel, G., Acharya, R., George, A., Borgnakke, W. S., & Rawal, L. B. (2024). Oral health and healthy ageing: a scoping review. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-023-04613-7 Phillips, L. A., Coan, L., & Wijesuriya, U. A. (2023). Dental and primary care professionals learning and collaborating to improve oral health. Journal of Dental Education, 87(S3), 1819-1821. https://doi.org/10.1002/jdd.13205 Christian, B. T., George, A., Veginadu, P., Villarosa, A. R., Makino, Y., Kim, W. J., … & Mijares-Majini, M. C. (2023). Strategies to integrate oral health into primary care: a systematic review. BMJ Open, 13(7), e070622. https://doi.org/10.1136/bmjopen-2022-070622 Gottlieb, M., Haas, M. R. C., Daniel, M., & Chan, T. M. (2021). The scoping review: A flexible, inclusive, and iterative approach to knowledge synthesis. AEM education and training, 5 (3), e10609. https://doi.org/10.1002/aet2.10609 Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033. Arksey, H. & O'Malley, L. (2005) Scoping studies: towards a methodological framework. International Journal of Social R. https://doi.org/10.1080/1364557032000119616 Basheer, N.A., & Jodalli, P. (2024, August 12). N, A. B., & Jodalli, P. (2024, August 12). Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: A scoping review. https://doi.org/10.17605/OSF.IO/EX7M6 JBI (2024). Available at: https://jbi-global-wiki.refined.site/space/MANUAL/355862667/10.2.2+Developing+the+title+and+question. McGowan, J., Sampson, M., Salzwedel, D.M., Cogo, E., Foerster, V. and Lefebvre, C. (2016). PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. Journal of Clinical Epidemiology, 75(1), pp.40–46. Mourad Ouzzani, Hossam Hammady, Zbys Fedorowicz, and Ahmed Elmagarmid. Rayyan — a web and mobile app for systematic reviews. Systematic Reviews (2016) 5:210, DOI: 10.1186/s13643-016-0384-4. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372 , n71. https://doi.org/10.1136/bmj.n71 Microsoft Corporation: Microsoft excel. 2018. Available at: https://www.microsoft.com/en-in/microsoft-365/excel. Supplementary Files Supplementaryfile1.docx Supplementaryfile2.docx Cite Share Download PDF Status: Published Journal Publication published 18 Mar, 2026 Read the published version in Systematic Reviews → Version 1 posted Reviewers agreed at journal 17 Oct, 2025 Reviewers invited by journal 16 Oct, 2025 Editor assigned by journal 25 Sep, 2025 First submitted to journal 25 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4961741","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":530819523,"identity":"170a2a8c-84d2-450e-9ced-0d566e83bfc5","order_by":0,"name":"Amitha Basheer N","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0002-5907-4333","institution":"Manipal College of Dental Sciences - Mangalore","correspondingAuthor":true,"prefix":"","firstName":"Amitha","middleName":"Basheer","lastName":"N","suffix":""},{"id":530819524,"identity":"72946a34-8fd1-4557-947c-876cca05de98","order_by":1,"name":"Praveen Jodalli","email":"","orcid":"","institution":"Manipal College of Dental Sciences - Mangalore","correspondingAuthor":false,"prefix":"","firstName":"Praveen","middleName":"","lastName":"Jodalli","suffix":""},{"id":530819525,"identity":"28675208-3578-478b-83b8-14a649a34c3f","order_by":2,"name":"Shishir Ram Shetty","email":"","orcid":"","institution":"University of Sharjah College of Dental Medicine","correspondingAuthor":false,"prefix":"","firstName":"Shishir","middleName":"Ram","lastName":"Shetty","suffix":""},{"id":530819526,"identity":"573c591c-43a0-4f08-b3ad-6ea9a2c9c8ca","order_by":3,"name":"Ramya Shenoy","email":"","orcid":"","institution":"Manipal College of Dental Sciences - Mangalore","correspondingAuthor":false,"prefix":"","firstName":"Ramya","middleName":"","lastName":"Shenoy","suffix":""},{"id":530819527,"identity":"dad28a59-3a93-4c46-a958-202720d5db04","order_by":4,"name":"Ashwini Rao","email":"","orcid":"","institution":"Manipal College of Dental Sciences - Mangalore","correspondingAuthor":false,"prefix":"","firstName":"Ashwini","middleName":"","lastName":"Rao","suffix":""},{"id":530819528,"identity":"b4dced49-3a29-4043-a6b3-0b8db4bc2b12","order_by":5,"name":"Mithun Pai","email":"","orcid":"","institution":"Manipal College of Dental Sciences - Mangalore","correspondingAuthor":false,"prefix":"","firstName":"Mithun","middleName":"","lastName":"Pai","suffix":""},{"id":530819529,"identity":"a4065a18-b2a0-4536-a3b9-610864ffa9f4","order_by":6,"name":"Avinash B R","email":"","orcid":"","institution":"Manipal College of Dental Sciences - Mangalore","correspondingAuthor":false,"prefix":"","firstName":"Avinash","middleName":"B","lastName":"R","suffix":""}],"badges":[],"createdAt":"2024-08-23 05:53:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4961741/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4961741/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13643-026-03136-7","type":"published","date":"2026-03-18T15:59:24+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":94844402,"identity":"39a8ddb9-bd8a-487e-9ece-3d549b1deef7","added_by":"auto","created_at":"2025-10-31 09:55:22","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11680,"visible":true,"origin":"","legend":"","description":"","filename":"sysrSYSRD2400833.xml","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/63803d6be05d42230760eddc.xml"},{"id":94844409,"identity":"e0e6993a-65d7-44b2-a2a7-618473f32419","added_by":"auto","created_at":"2025-10-31 09:55:22","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1067,"visible":true,"origin":"","legend":"","description":"","filename":"SYSRD240083323429.go.xml","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/6f61a191be02262c9add4a9a.xml"},{"id":94844406,"identity":"f1f97793-8c4c-4187-ac01-5d2d9e57a76d","added_by":"auto","created_at":"2025-10-31 09:55:22","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":914,"visible":true,"origin":"","legend":"","description":"","filename":"SYSRD2400833Import.xml","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/1041dddccd362cb26060c744.xml"},{"id":94844407,"identity":"bad2e8fd-fa13-4db0-99d7-2396bc76baab","added_by":"auto","created_at":"2025-10-31 09:55:22","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":64342,"visible":true,"origin":"","legend":"","description":"","filename":"SYSRD24008331enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/1dca53a7230edbeb29e06aae.xml"},{"id":94985595,"identity":"496b6bac-3ffd-4f65-a4cf-882a95a602e4","added_by":"auto","created_at":"2025-11-03 06:58:29","extension":"xml","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":61295,"visible":true,"origin":"","legend":"","description":"","filename":"SYSRD24008331structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/89fab0d4dba488f3ab0eca4a.xml"},{"id":94985581,"identity":"97d9ea54-b91a-48e2-a410-b7076d1024f5","added_by":"auto","created_at":"2025-11-03 06:58:27","extension":"html","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":70340,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/13a422e436eedeafb11fa3e5.html"},{"id":105223430,"identity":"9f688895-5ba2-42b3-a370-20ce606e8182","added_by":"auto","created_at":"2026-03-23 16:06:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":595047,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/3065ff27-406b-4331-bbed-fd7c181092d1.pdf"},{"id":94844403,"identity":"ad9ade86-8a1f-4ff6-8be7-8db90bcae22f","added_by":"auto","created_at":"2025-10-31 09:55:22","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":17620,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/dc7282c1f8ae2f96565b312c.docx"},{"id":94844404,"identity":"2022d8af-8b85-47f1-bf04-a084ca30eca6","added_by":"auto","created_at":"2025-10-31 09:55:22","extension":"docx","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":15748,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile2.docx","url":"https://assets-eu.researchsquare.com/files/rs-4961741/v1/76c279b379a6bede0bf69482.docx"}],"financialInterests":"","formattedTitle":"Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: Protocol for a scoping review","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eOral health is a crucial indicator of general health, well-being, and quality of life, with a close and complex relationship to systemic outcomes\u0026sup1;. Oral conditions are among the most common noncommunicable diseases; about 45% of the world\u0026rsquo;s population experience them across the life course\u0026sup2;. As a determinant of overall health, oral health influences daily functioning and general health outcomes\u0026sup3;. Poor oral health leads to dental caries, periodontal diseases, and oral infections that affect oral structures and can have systemic consequences\u0026sup3;.\u003c/p\u003e\u003cp\u003eRegular oral health assessments (OHA) are necessary to monitor changes in oral health status and evolving needs⁴. Such assessments help identify areas for improvement in clinical practice and address deficiencies in oral health knowledge and behavior⁵. The strong bidirectional relationship between oral and general health highlights the importance of integrating oral health into healthcare practice⁶. Despite its significance, oral health is often neglected in healthcare delivery. At many health settings, oral health components are overlooked, hindering the implementation of integrated care⁷. Dentistry has historically been isolated from mainstream health systems, with much care delivered by private practitioners rather than within public health frameworks. As a result, oral health has frequently been viewed as a marginal issue of low priority\u0026sup2;.\u003c/p\u003e\u003cp\u003eNDHP including physicians, nurses, and allied health workers, form an intrinsic part of the health system⁸. Through their interactions with patients across a wide range of medical conditions, they are strategically positioned to promote oral health as part of comprehensive patient care⁸. Over the past two decades, several OHA tools have been developed for NDHP to facilitate early identification, monitoring, and referral of oral problems⁹. Research has shown that embedding OHA and health-promotion competencies into continuing education for NDHP enhances the delivery of oral healthcare⁶. These tools enable NDHP to support early detection, prevention, and management of oral conditions, thereby improving outcomes\u0026sup1;⁰. Continuous development and validation of such tools are essential to address psychometric gaps and ensure comprehensive coverage of OHA domains\u0026sup1;\u0026sup1;.\u003c/p\u003e\u003cp\u003eUse of these tools by NDHP is crucial for preventing oral diseases, promoting oral health, and ensuring timely referral to dental care\u0026sup1;\u0026sup2;. Indigenous and community health workers have also been shown to play an important role in contexts such as promoting oral health in pregnancy, emphasizing the need for tailored interventions for different populations\u0026sup1;\u0026sup2;. Accordingly, policy measures, training programs, and collaborative care models have been proposed to expand the role of non-dental primary care providers in delivering OHA, particularly general practitioners and nurses\u0026sup1;\u0026sup3;. Standardized instruments, such as the Oral Health Assessment Tool (OHAT), have been advocated to support screening, triage, and referral\u0026sup1;⁴. Equipping healthcare providers with adequate knowledge and skills helps overcome systemic barriers to health and well-being, particularly in vulnerable groups\u0026sup1;⁵.\u003c/p\u003e\u003cp\u003eThe development and validation of OHA instruments for NDHP remain important to improve the quality of care and outcomes, especially for vulnerable populations⁶. Collaborative, transdisciplinary approaches between dental and medical professionals have shown effectiveness in assessing and managing oral health, particularly for patients with complex medical conditions\u0026sup1;\u0026sup1;. Extending the responsibilities of NDHP in this area is a promising strategy to enhance both oral and general health outcomes\u0026sup1;⁶.\u003c/p\u003e\u003cp\u003eIntegrating oral health into primary care is therefore essential to address gaps in OHA and management by NDHP\u0026sup1;⁷. Such integration supports holistic healthcare delivery, improves accessibility and affordability of oral care\u0026sup2;,\u0026sup1;⁰, and strengthens population health outcomes. With appropriate tools, targeted training, and collaboration with dental professionals, NDHP can significantly contribute to oral health promotion and early management across diverse settings.\u003c/p\u003e\u003cp\u003eGiven this background, the present review aims to systematically identify and map the oral health assessment tools developed for use by NDHP across diverse care settings, while evaluating their scope, application, and psychometric properties.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003eA scoping review is the better approach in assessing OHA tools for NDHP considering the comprehensiveness and exploratory nature associated with it, besides its capacity for comprehensive mapping of available literature. In this way, a scoping review enables broad examination of the available literature, including several designs, methodologies, and sources in mapping out available evidence on this topic. \u003csup\u003e18\u0026nbsp;\u003c/sup\u003eIt shall provide good scrutiny on the subject area under study to give insights into different tools, psychometric properties, and applications, and their impact on oral health.\u003c/p\u003e\n\u003cp\u003eThe current review will follow the reporting standards specified in the scoping review extension PRISMA-ScR\u003csup\u003e19\u003c/sup\u003e. The approach will adhere to the five stages established in Arksey and O\u0026apos;Malley\u0026apos;s methodological framework, which offers a comprehensive conceptual scope appropriate for capturing a diverse variety of relevant research \u003csup\u003e20\u003c/sup\u003e. Using this methodology, the scoping review will thoroughly map the available literature on OHA tools used by NDHP. This protocol is prospectively registered in\u0026nbsp;Open Science Framework (OSF) registration platform \u003csup\u003e21\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStage 1: Identifying the research question\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePCC (Population Concept Context) framework was used to frame the research question \u003csup\u003e22\u003c/sup\u003e. PCC elements and its descriptions are provided in Table1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: PCC framework\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18.802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePCC elements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81.198%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDescription\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18.802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePopulation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81.198%;\"\u003e\n \u003cp\u003eNon-dental healthcare professionals involved in oral health assessment (e.g., physicians, nurses, allied health workers).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18.802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConcept\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81.198%;\"\u003e\n \u003cp\u003eOral health assessment tools designed for use by non-dental healthcare professionals, including those developed or validated. The review will consider tools with available information on their scope, application, and psychometric properties.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18.802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContext\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81.198%;\"\u003e\n \u003cp\u003eAny clinical, community, or rehabilitation setting, irrespective of geographic location, where such oral health assessment tools have been utilized, tested, or validated.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eResearch questions:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eWhat oral health assessment tools are available for use by NDHP, and in which settings (clinical, community, or rehabilitation) have they been utilized, tested, or validated.?\u003c/li\u003e\n \u003cli\u003eWhat evidence exists regarding the scope, application, and psychometric properties of these tools?\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eStage 2: Identifying relevant studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis stage involves developing a search strategy plan, involving decisions regarding search resources, keywords, publishing time frame, and language.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eSearch sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA comprehensive search strategy was developed, incorporating specific keywords related to OHA tools and NDHP. A preliminary search was performed in three databases: PubMed, Scopus, and Web of Science, to identify relevant articles on OHA tools for NDHP. Proposed search terms and their synonyms with preliminary search results are presented in supplementary material 1. Keywords/MeSH terms and their alternate terms were used in combination with Boolean operators \u0026lsquo;OR\u0026rsquo; and \u0026lsquo;AND\u0026rsquo; to retrieve relevant studies. A PRESS (Peer Review of Electronic Search Strategies) checklist will be used to assess the quality of search strategies to ensure that search strategies are comprehensive, transparent, and replicable, thereby minimizing the risk of bias in the review process\u003csup\u003e23\u003c/sup\u003e. In addition, the reference lists of all selected studies will be manually reviewed to identify other relevant papers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEligibility criteria\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion criteria\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003ePeer-reviewed primary studies\u003c/li\u003e\n \u003cli\u003eStudies published in English from inception to June 30, 2025.\u003c/li\u003e\n \u003cli\u003eStudies involving non-dental healthcare professionals such physicians, nurses, allied health workers, community health workers, caregivers.\u003c/li\u003e\n \u003cli\u003eStudies reporting on the development, testing, validation, or utilization of oral health assessment tools in any setting clinical, community, rehabilitation).\u003c/li\u003e\n \u003cli\u003eStudies that describe tool characteristics, with or without psychometric evaluation (e.g., reliability, validity).\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eExclusion criteria\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eStudies that focus exclusively on dental professionals as users of OHA tools.\u003c/li\u003e\n \u003cli\u003eSecondary literature (systematic reviews, scoping reviews, meta-analyses, narrative reviews), editorials, commentaries, conference abstracts, and other grey literature.\u003c/li\u003e\n \u003cli\u003eNon-English publications.\u003c/li\u003e\n \u003cli\u003eArticles without accessible full text, after attempting to contact corresponding authors.\u003c/li\u003e\n \u003cli\u003eStudies that do not evaluate or describe an OHA tool or those addressing only oral health knowledge, attitudes, or general outcomes without an assessment instrument.\u003c/li\u003e\n \u003cli\u003eGray literature will not be included in this review. The decision was made to ensure that only peer-reviewed, methodologically rigorous studies are analyzed, thereby enhancing the reliability and reproducibility of findings. While gray literature may provide additional information, it often lacks adequate methodological detail and peer-review verification, which may introduce bias or compromise quality.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eFor studies where only abstracts are available, attempts will be made to obtain the full text by contacting the corresponding authors. Only if the full text remains inaccessible after these efforts will the study be excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStage 3: Selection of studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll references that are the result of the comprehensive search strategy will initially be exported into Rayyan software\u003csup\u003e24\u003c/sup\u003e. This will allow managing these references to have an organized workflow. As imported, Rayyan will automatically indicate and highlight the potential duplicate references. These duplicates will have to be manually reviewed and confirmed before removal to ensure that no relevant studies are missed out.\u003c/p\u003e\n\u003cp\u003eThe next step involves a thorough screening of the titles and abstracts of the remaining references. Two reviewers will do this independently to avoid bias and increase reliability in the selection process. The reviewers will assess each study against the predefined inclusion and exclusion criteria to determine its relevance to the scoping review. Any irrelevant studies will be eliminated at this stage. Full-text articles of the studies passed by this initial screening will be obtained for a more in-depth review. The full texts will then be retrieved and screened independently by two reviewers. In this phase, the reviewers will look for details about the type of study design, characteristics of the population involved, the tool, and its psychometric properties.\u003c/p\u003e\n\u003cp\u003eIn case there is some discrepancy between the two reviewers on any study with respect to its inclusion or exclusion, such discrepancies shall be resolved through discussions. If the need for consensus by the two reviewers is still not reached, then consultation with a third reviewer will ensue. The third reviewer will, in turn, review that study independently; his/her decision shall be final. This process ensures that the selection of studies is fair and unbiased.\u003c/p\u003e\n\u003cp\u003eThe whole process of selection will be documented, and it will include the reasons for excluding studies. The PRISMA flow diagram describes the flow of studies through the selection process\u003csup\u003e25\u003c/sup\u003e. This will contain the total number of studies identified, screened, and eligible, and included in the review, the number excluded at each stage, and the reason for exclusion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStage 4: Charting the data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter the studies are selected, data extraction from the studies will be done and entered in Microsoft Excel \u003csup\u003e26\u003c/sup\u003e. A priori, a standardised data charting form will utilize in this review, which will capture all the relevant data from studies. It will capture information such as author(s), year of publication, title, country, health setting, study design, setting, population characteristics (age, gender, profession), sample size, psychometric properties: validity and reliability, outcomes, and key findings of studies (supplementary file 2). To increase homogeneity in data extraction, two reviewers will do it independently with a third reviewer to resolve the discrepancies. In the process, a detailed log will be maintained of any decisions taken during data extraction. Deviations from the original strategy will be documented in the review\u0026apos;s methodology section.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePilot testing of the data charting form\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data charting form will be pilot-tested on a sample of \u003cstrong\u003e5 studies\u003c/strong\u003e that meet the eligibility criteria. Two independent reviewers will extract data from this subset to evaluate whether the form captures all relevant information consistently and reliably. Discrepancies between reviewers will be discussed and resolved with the involvement of a third reviewer if necessary. Based on the outcomes of this pilot, the data charting form will be refined to improve clarity, consistency, and comprehensiveness before being applied to the full set of included studies. Any modifications made during this process will be documented in the protocol and reported in the final review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStage 5: Collating, Summarizing and Reporting Results\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSummary tables will be produced providing an overview of the key characteristics of included studies. It will help identify patterns across studies, including gaps in the literature. A descriptive summary of the included studies will be given. This comprises a narrative account of the number of studies, their distribution by type, geographical location, populations studied, and other relevant characteristics. A descriptive narrative synthesis will be done, with a view to answering the research questions, providing insight into the overall evidence base. In addition to the narrative synthesis, data would be represented using tables, or maps of trends or gaps in research. Where appropriate, subgroupings such as healthcare professional type or care setting will be done to provide additional insights.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eStatus of the study\u0026nbsp;\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe protocol is currently registered on the Open Science Framework registration portal. \u0026nbsp;https://doi.org/10.17605/OSF.IO/EX7M6 , and an initial search has been conducted. The title, abstracts, and index terms of the papers retrieved have been examined for keywords and search terms relevant to the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDissemination of data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data collected or the results from the review will be disseminated through academic journals, conferences, and institutional repositories so that the findings will reach and benefit the targeted community, researchers, practitioners, and policymakers.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis scoping review process has been established for the careful analysis and mapping of the landscape associated with OHA tools used by NDHP across various contexts. The review will identify literature gaps in the scope, structure, and psychometric properties of these tools and to provide an overview of available evidence through a detailed examination of the same. The findings will be used to guide the development and enhancement of assessment practices in oral health by non-dental health care providers about holistic and integrated health care delivery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eNDHP: Non-dental health professionals\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOHA: Oral health assessment\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOHAT: Oral health assessment tool\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOSF: Open Science Framework\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePRISMA:\u0026nbsp;Preferred Reporting Items for Systematic Reviews and Meta-Analyses\u003c/p\u003e\n\u003cp\u003ePRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval and Consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study will include secondary data from published articles; therefore it does not need ethical approval and consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo data associated with this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing interests declared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding has been received for this study\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eABN and PJ performed \u0026nbsp;acquisition of data, drafted the article, review and editing of draft, revision of the article and final approval of the version.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSSR, RS,AR,MP,ABR performed drafting of article and review and editing of draft. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBasheer N A, Jodalli P, Ram Shetty S, Shenoy R, Rao A, Pai M, B R A, Nayak N. (2024). Development and Validation of \u0026ldquo;Basic Oral Health Assessment Tool\u0026rdquo; (BOHAT) for Non-Dental Healthcare Professionals for Indian Adult Population: A Mixed Method Research JMIR Preprints. 21/06/2024:63480. https://doi.org/10.2196/preprints.63480\u0026zwnj;\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (2022). The Global Status Report on Oral Health 2022. [online] Available at: https://www.who.int/team/noncommunicable-diseases/global-status-report-on-oral-health-2022. \u003c/li\u003e\n\u003cli\u003eNemati, S., Ghasempour, M., \u0026amp; Khafri, S. (2016). Impact of oral and dental health on quality of life in Iranian preschool children and their families. Electronic Physician, 8(11), 3296-3301. https://doi.org/10.19082/3296 \u003c/li\u003e\n\u003cli\u003eBrega, A. G., Johnson, R. L., Jiang, L., Wilson, A., Schmiege, S. J., \u0026amp; Albino, J. (2021). Influence of parental health literacy on change over time in the oral health of American Indian children. International Journal of Environmental Research and Public Health, 18(11), 5633. https://doi.org/10.3390/ijerph18115633\u003c/li\u003e\n\u003cli\u003eRodrigues, A., Hegde, V., Hegde, A., Shastri, S., Ravikumar, D., \u0026amp; Rodrigues, R. (2021). An exploration of the oral health beliefs and behaviours of people living with HIV in Mangalore, India: a qualitative study. BMC Oral Health, 21(1). https://doi.org/10.1186/s12903-021-01549-5 \u003c/li\u003e\n\u003cli\u003eKossioni, A., Hajto‐Bryk, J., Maggi, S., McKenna, G., Petrovic, M., Roller‐Wirnsberger, R., \u0026amp; M\u0026uuml;ller, F. (2017). An expert opinion from the European college of gerontology and the European geriatric medicine society: European policy recommendations on oral health in older adults. Journal of the American Geriatrics Society, 66(3), 609-613. https://doi.org/10.1111/jgs.15191\u003c/li\u003e\n\u003cli\u003eDuangthip, D., \u0026amp; Chu, C. H. (2020). Challenges in Oral Hygiene and Oral Health Policy. \u003cem\u003eFrontiers in oral health\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e, 575428. https://doi.org/10.3389/froh.2020.575428\u003c/li\u003e\n\u003cli\u003eSabbahi, D. (2023). The effectiveness of oral health education among non-dental healthcare professionals in Jeddah, Saudi Arabia: a quasi-experimental study. Cureus. https://doi.org/10.7759/cureus.49187\u003c/li\u003e\n\u003cli\u003eThapa, R., Chimoriya, R., \u0026amp; Arora, A. (2021). The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-020-01989-8\u003c/li\u003e\n\u003cli\u003eEveraars, B., Weening-Verbree, L., Jerković-Ćosić, K., Schoonmade, L. J., Bleijenberg, N., Wit, N. J. d., ..\u0026amp; Heijden, G. J. M. G. v. d. (2020). Measurement properties of oral health assessments for non-dental healthcare professionals in older people: a systematic review. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-019-1349-y \u003c/li\u003e\n\u003cli\u003eObana, M., Furuya, J., Matsubara, C., Tohara, H., Inaji, M., Miki, K., \u0026hellip; \u0026amp; Maehara, T. (2019). Effect of a collaborative transdisciplinary team approach on oral health status in acute stroke patients. Journal of Oral Rehabilitation, 46(12), 1170-1176. https://doi.org/10.1111/joor.12855\u003c/li\u003e\n\u003cli\u003eVillarosa, A. C., Villarosa, A. R., Salamonson, Y., Ramjan, L. M., Sousa, M. S., Srinivas, R., \u0026hellip; \u0026amp; George, A. (2018). The role of indigenous health workers in promoting oral health during pregnancy: a scoping review. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5281-4 \u003c/li\u003e\n\u003cli\u003eOno, K., Hironaka, S., Utsumi, A., Yamaguchi, A., Shibata, Y., Osakabe, L., \u0026hellip; \u0026amp; Maruoka, Y. (2024). Effective oral indicators with medical and dental collaboration in open heart surgery: a representative survey. Cureus. https://doi.org/10.7759/cureus.62392\u003c/li\u003e\n\u003cli\u003eSuzuki, H., Furuya, J., Nakagawa, K., Hidaka, R., Nakane, A., Yoshimi, K., \u0026hellip; \u0026amp; Minakuchi, S. (2023). Factors influencing the selection of oral healthcare providers in multidisciplinary nutrition support team for malnourished inpatients: a cross‐sectional study. Journal of Oral Rehabilitation, 50(12), 1446-1455. https://doi.org/10.1111/joor.13565\u003c/li\u003e\n\u003cli\u003ePoudel, P., Paudel, G., Acharya, R., George, A., Borgnakke, W. S., \u0026amp; Rawal, L. B. (2024). Oral health and healthy ageing: a scoping review. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-023-04613-7\u003c/li\u003e\n\u003cli\u003ePhillips, L. A., Coan, L., \u0026amp; Wijesuriya, U. A. (2023). Dental and primary care professionals learning and collaborating to improve oral health. Journal of Dental Education, 87(S3), 1819-1821. https://doi.org/10.1002/jdd.13205\u003c/li\u003e\n\u003cli\u003eChristian, B. T., George, A., Veginadu, P., Villarosa, A. R., Makino, Y., Kim, W. J., \u0026hellip; \u0026amp; Mijares-Majini, M. C. (2023). Strategies to integrate oral health into primary care: a systematic review. BMJ Open, 13(7), e070622. https://doi.org/10.1136/bmjopen-2022-070622\u003c/li\u003e\n\u003cli\u003eGottlieb, M., Haas, M. R. C., Daniel, M., \u0026amp; Chan, T. M. (2021). The scoping review: A flexible, inclusive, and iterative approach to knowledge synthesis. AEM education and training, \u003cem\u003e5\u003c/em\u003e(3), e10609. https://doi.org/10.1002/aet2.10609\u003c/li\u003e\n\u003cli\u003eTricco AC, Lillie E, Zarin W, O\u0026apos;Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tun\u0026ccedil;alp \u0026Ouml;, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033.\u003c/li\u003e\n\u003cli\u003eArksey, H. \u0026amp; O\u0026apos;Malley, L. (2005) Scoping studies: towards a methodological framework. International Journal of Social R. https://doi.org/10.1080/1364557032000119616\u003c/li\u003e\n\u003cli\u003eBasheer, N.A., \u0026amp; Jodalli, P. (2024, August 12). N, A. B., \u0026amp; Jodalli, P. (2024, August 12). Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: A scoping review. https://doi.org/10.17605/OSF.IO/EX7M6 \u003c/li\u003e\n\u003cli\u003eJBI (2024). Available at: https://jbi-global-wiki.refined.site/space/MANUAL/355862667/10.2.2+Developing+the+title+and+question. \u003c/li\u003e\n\u003cli\u003eMcGowan, J., Sampson, M., Salzwedel, D.M., Cogo, E., Foerster, V. and Lefebvre, C. (2016). PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement. Journal of Clinical Epidemiology, 75(1), pp.40\u0026ndash;46.\u003c/li\u003e\n\u003cli\u003eMourad Ouzzani, Hossam Hammady, Zbys Fedorowicz, and Ahmed Elmagarmid. Rayyan \u0026mdash; a web and mobile app for systematic reviews. Systematic Reviews (2016) 5:210, DOI: 10.1186/s13643-016-0384-4.\u003c/li\u003e\n\u003cli\u003ePage, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hr\u0026oacute;bjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., \u0026hellip; Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. \u003cem\u003eBMJ \u003c/em\u003e(Clinical research ed.), \u003cem\u003e372\u003c/em\u003e, n71. https://doi.org/10.1136/bmj.n71 \u003c/li\u003e\n\u003cli\u003eMicrosoft Corporation: Microsoft excel. 2018. Available at: https://www.microsoft.com/en-in/microsoft-365/excel. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Oral health assessment, Non-dental healthcare professionals, Psychometric properties, Oral health tools, Integrated healthcare, Holistic care, Scoping review","lastPublishedDoi":"10.21203/rs.3.rs-4961741/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4961741/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eOral health is a significant indicator of overall wellness and health, although it is often ignored in general healthcare. Despite the development of various oral health assessment (OHA) tools for non-dental health professionals (NDHP), there is limited comprehensive understanding of their scope, and application, This scoping review will systematically explore the available research on OHA tools used by non-dental healthcare providers, focusing on their development, psychometric properties, and utilization across different settings.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eArksey and O'Malley framework will direct this review and will be reported in line with the PRISMA-ScR guidelines. A comprehensive search strategy has been developed and preliminary search was conducted in three major databases: PubMed, Scopus, and Web of Science. The search will include studies from inception to June 30, 2025. Studies will be selected based on predefined inclusion and exclusion criteria. Data charting will be done using a charting form and analysed through narrative synthesis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe review will provide a detailed mapping of the OHA tools currently available for non-dental healthcare providers, including their psychometric properties, settings of use, and the populations they target. The analysis will identify gaps in the literature and highlight the tools that are most effective in promoting early detection and management of oral health issues by NDHP.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis scoping study will provide a detailed overview of the oral health screening tools available to non-dental healthcare professionals, shedding light on their utility, and areas requiring further research.\u003c/p\u003e","manuscriptTitle":"Improving the evidence base for oral health assessment tools for non-dental healthcare professionals: Protocol for a scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-31 09:55:17","doi":"10.21203/rs.3.rs-4961741/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2025-10-17T16:43:15+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-16T18:50:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-26T03:33:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"Systematic Reviews","date":"2025-09-25T10:35:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"527c39a9-6845-4c9b-a777-6c014f328fd1","owner":[],"postedDate":"October 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T16:02:58+00:00","versionOfRecord":{"articleIdentity":"rs-4961741","link":"https://doi.org/10.1186/s13643-026-03136-7","journal":{"identity":"systematic-reviews","isVorOnly":false,"title":"Systematic Reviews"},"publishedOn":"2026-03-18 15:59:24","publishedOnDateReadable":"March 18th, 2026"},"versionCreatedAt":"2025-10-31 09:55:17","video":"","vorDoi":"10.1186/s13643-026-03136-7","vorDoiUrl":"https://doi.org/10.1186/s13643-026-03136-7","workflowStages":[]},"version":"v1","identity":"rs-4961741","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4961741","identity":"rs-4961741","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}