What do systematic reviews say?

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
  19 studies
  GRADE not reported

Primary care professionals vs ordinary emergency department physicians

It is very uncertain whether primary care professionals changes time from arrival to clinical assessment and treatment compared with ordinary emergency department physicians (very low certainty).

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  MD 2.1
  1 study · 260 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

It is very uncertain whether primary care professionals changes total length of ED stay compared with ordinary emergency department physicians (very low certainty).

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 260 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

It is very uncertain whether primary care professionals changes admission to hospital compared with ordinary emergency department physicians (very low certainty).

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 11203 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

It is very uncertain whether primary care professionals changes diagnostic tests compared with ordinary emergency department physicians (very low certainty).

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 11203 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

It is very uncertain whether primary care professionals changes treatments given compared with ordinary emergency department physicians (very low certainty).

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 11203 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

It is very uncertain whether primary care professionals changes consultations or referrals to hospital‐based specialists compared with ordinary emergency department physicians (very low certainty).

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 11203 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 9325 participants
  Very low

Primary care professionals vs ordinary emergency department physicians

The review found no eligible studies for this question.

• Primary care professionals providing non‐urgent care in hospital emergency departments 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Integration strategies were generally associated with positive oral health knowledge, attitudes and perceptions among staff and patients (16 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Knowledge/attitudes/perceptions of staff and patients was the second most studied outcome (n=16). Patient and staff perceptions on various aspects of the integration strategy were usually reported as positive.…
  16 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
  15 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
  9 studies
  GRADE not reported