# Improving Oral Health After Spinal Cord Injury: A Scoping Review of Barriers, Facilitators, Current Interventions and Their Effectiveness

## TL;DR

This review explores how non-dental health professionals can help improve oral health in people with spinal cord injuries, highlighting barriers, facilitators, and current interventions.

## Contribution

The study maps barriers and facilitators for non-dental professionals promoting oral health in spinal cord injury patients and evaluates intervention effectiveness.

## Key findings

- Non-dental professionals face barriers like limited resources but benefit from education and training.
- Five interventions improved oral health outcomes, practices, and knowledge among spinal cord injury patients.
- Current interventions do not address all barriers, highlighting a need for further research.

## Abstract

Oral health promotion interventions promoted by non‐dental health professionals can optimize clinical outcomes and overall well‐being among people with spinal cord injury (PWSCI). Many barriers and facilitators affect non‐dental health professionals' ability to promote oral health interventions among PWSCI. This scoping review aims to map the barriers, facilitators, and current oral health promotion interventions, and to assess their effectiveness among PWSCI.

Using Arksey and O'Malley's scoping review framework, a systematic search of six databases (e.g., Embase, MEDLINE, CINAHL, Web of Science, Scopus, and PubMed) and Google Scholar for published studies inEnglish was conducted. All articles published up until November 2024 were included. The PRISMA‐Scoping Reviews Checklist was applied to guide this review's structure.

Of the 1352 records identified, seven studies were included. Many individual and system‐level barriers (limited resources and staff, etc.) and facilitators (education and training) reported by non‐dental health professionals (nurses, occupational therapists, clinical dietitians, speech pathologists etc.) were identified. Five oral health interventions for PWSCI were reported, including oral health education and training. These interventions optimized oral health outcomes (activities of daily living, quality of life, independence in toothbrushing, reducing gingival inflammation), improved oral health practices (e.g., sustaining long‐term dental hygiene habits and improving independence in dental hygiene habits, and accessibility to geographically dispersed PWSCI) and enhanced knowledge about dental hygiene among them.

Non‐dental health professionals can be key in promoting oral health. Although many barriers impede their ability to promote oral health, currently, there are no interventions to address these barriers and enhance their ability to optimize oral health. Therefore, more research is needed to identify appropriate interventions that can enable non‐dental health professionals to address the barriers, identify oral health issues, and integrate oral health into general healthcare.