USPSTF finalizes recommendation on oral health screening in primary care

Key takeaways:

• The USPSTF said it could not make a recommendation on oral health screening in youth and adults.
• Experts said physicians should build evidence by inquiring about oral health with patients.

There is insufficient evidence to rule for or against oral health screening and preventive interventions in adults and youth aged 5 years and older, the U.S. Preventive Services Task Force declared in a final recommendation statement.

The I-grade recommendation is consistent with task force’s draft recommendation released in May.

“The task force needs more evidence on whether and how primary care professionals can promote good oral health in school-aged children, adolescents and adults,” USPSTF member John Ruiz, PhD, said in a press release. “Healthy teeth and gums are an important part of overall health, so it is essential that research focuses on oral health screening and preventive interventions in the primary care setting.”

The task force based their recommendation on a review of 23 studies in children and 16 studies in adults.

According to the USPSTF, risk factors for developing oral health problems can include tobacco, a lack of flossing and high-sugar diets. Social factors, like no dental insurance or low socioeconomic status, can also contribute to development.

Despite the lack of evidence, “the task force recognizes that many people lack access to dental care, so primary care professionals should use their judgment when deciding whether to screen or perform preventive interventions related to oral health,” USPSTF member Li Li, MD, PhD, MPH, said in the release.

In a related editorial, Michael S. Reddy, DMD, DMSc, dean of the University of California, Los Angeles School of Dentistry, and colleagues called for a partnership between dentistry and primary care.

“Without a coordinated effort, highly preventable oral health disparities and poorer overall health outcomes will persist,” they wrote. “Care coordination improves both oral and overall health.”

The authors also encouraged physicians to build evidence by asking patients about oral hygiene, signs or symptoms of dental issues, their last dental visit and to “refer to a dentist if necessary.”

References:

• Chou R, et al. JAMA. 2023;doi:10.1001/jama.2023.20435
• Chou R, et al. JAMA. 2023;doi:10.1001/jama.2023.20685
• Reddy M, et al. JAMA. 2023;doi:10.1001/jama.2023.22005
• U.S. Preventive Services Task Force issues final recommendations on screening and preventive interventions for oral health. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/oral-health-screening-interventions-final-rec-bullletin.pdf. Published Nov. 7, 2023. Accessed Nov. 7, 2023.
• US Preventive Services Task Force (USPSTF). JAMA. 2023;doi:10.1001/jama.2023.21409
• US Preventive Services Task Force (USPSTF). JAMA. 2023;doi:10.1001/jama.2023.21408