The latest issue of the RCP’s Future Healthcare Journal (FHJ) calls for oral health to be more closely integrated into medicine, highlighting its importance to prevention, diagnosis and the management of wider health conditions.
The new issue of FHJ brings together evidence and perspectives on the relationship between oral and general health, and examines how closer collaboration between medicine and dentistry could improve patient care.
Guest edited by oral and maxillofacial surgeon Ms Jasmine Ho, the issue explores the influence of oral health across the life course, from childhood to older age. It considers its links with wider health conditions, inequalities in access to dental care and whether doctors receive enough training to recognise and respond to oral health problems.
In her editorial, Jasmine argues that the mouth should not be treated separately from the rest of the body. She highlights evidence linking gum disease and changes in the oral microbiome with wider health conditions, as well as the continuing difficulties many patients face in accessing NHS dental care. These pressures can have serious consequences. Tooth decay remains the leading cause of hospital admission among children aged 5–9 in the UK, while poor oral health can affect people’s wider health, quality of life and ability to access appropriate care.
Making oral health part of clinical practice
A central message running through the issue is that oral health should have a more consistent place in mainstream healthcare. In The forgotten organ, Dr Victoria Sampson examines the oral microbiome and its links with conditions including cardiovascular disease, diabetes and adverse pregnancy outcomes. She writes: ‘What can be said with more confidence is that the oral cavity is not isolated from the rest of the body, and that oral health deserves a more consistent place in general medical assessment and preventive care.’
The issue also considers whether oral health should be included more fully in undergraduate medical education. A debate article examines the case for giving medical students greater knowledge of dental problems and the oral signs of systemic disease.
Ms Jasmine Ho argues that greater understanding would help doctors reinforce preventive behaviours and work more effectively with dental colleagues. However, Ms Clarissa Hjalmarsson cautions against adding further pressure to already crowded medical curricula or transferring responsibility for dental care to doctors. She writes: ‘Shifting the responsibility for dental health onto medics will not solve the problems of an NHS dental system that fails to meet patients’ needs, and increases the risk of delay, misdiagnosis and mismanagement.’
A more preventive and equitable approach
Looking ahead, former chief dental officer for England Dr Sara Hurley sets out a vision for dentistry in 2050 based on prevention, earlier diagnosis and closer integration between oral health and wider healthcare services. Her article argues that scientific and technological advances must be accessible to all patients if they are to improve outcomes rather than widen existing inequalities. She describes the task as putting ‘the mouth back in the body: clinically, digitally, contractually and politically’.
A separate article on special care dentistry considers the needs of people who cannot access routine dental services because of physical, medical or social vulnerabilities. It highlights pressures on services and the importance of equitable access to oral healthcare for some of the NHS’s most vulnerable patients.
The clinician as patient
The consequences of fragmented care are brought into personal focus by oral and maxillofacial surgeon Mr Neil Shah, who reflects on being diagnosed with oral cancer after years of treating patients with the disease. Drawing on his experiences as both a clinician and a patient, he describes a ‘triad of care’ built around delay, certainty and dignity: ‘Delay, certainty and dignity are not peripheral to care. For patients, they are often what care feels like.’
The issue also includes articles on caring for people with multiple long-term conditions, leading healthcare innovation, measuring digital clinical work and helping clinicians navigate diagnostic uncertainty. Introducing the issue, FHJ editor-in-chief Dr Andrew Duncombe writes: ‘All physicians now need to be aware of the impact of oral health on organ systems and systemic disease.’