Guidelines, practices, and interprofessional roles in oral health promotion in custodial settings: a scoping review

Background: People in custodial settings are disproportionately affected by, often preventable, oral diseases. Addressing oral health inequities is vital to achieving the United Nations Sustainable Development Goals and Universal Health Coverage by 2030. Obstacles to achieving Universal Health Coverage for oral health in the custodial context include the deficit of oral health professionals in such settings. Innovative workforce models of non-dental professionals are recommended to integrate oral health into routine custodial care. Despite this, no comprehensive review has been undertaken to synthesise the evidence relating to the role of non-dental professionals working in custodial settings in providing oral health promotion. Methods: A scoping review, focusing on non-dental professionals working in custodial settings, was conducted from the data of database inception until 3 April 2024 examining oral health knowledge, attitudes and practices; availability of guidelines/recommendations; and oral health-related interventions. We conducted a comprehensive search for indexed and grey literature and initiated a global call for data. Results: Twenty-three sources of evidence from high-income countries (Australia, United Kingdom [UK], United States [USA]) met our inclusion criteria. Guidelines/recommendations defining the role of non-dental professionals in oral health promotion were located (n = 15), yet translation into clinical practice may be variable given the few practices located (n = 8). Nurses, physicians, and correctional officers were primarily involved in some aspect of oral health education, screening, treatment, and referral, highlighting the importance of interprofessional collaboration. Oral health-related knowledge was limited among nurses (n = 1) yet nurses may be receptive to potential training (n = 1). Nine interventions focussed on oral health-related prevention and management, including in-service training, resources, officer escort program, motivational interviewing and whole of prison education program, yet only three were evaluated. Correctional professionals reported oral health-related education and training as feasible, acceptable, and improved their knowledge, attitudes, and behaviours. Conclusions: Integrating essential oral health care into routine care among people in custodial settings needs to be prioritised. Championing the workforce reform agenda by strengthening and diversifying the oral health workforce in custodial settings can achieve this. Further research is required to explore innovative models of care involving non-dental professionals working in custodial settings. Registration: The protocol was registered with the Open Science Framework (OSF) (DOI 10.17605/OSF.IO/GPY76) before the review was conducted.