Open research questions in Dental Health and Care Utilization

What the literature leaves open

• In North Macedonia, recent national epidemiological studies are lacking; however, available regional data indicate a significant presence of total edentulism among individuals over 65 years of age.

  Epidemiological Characteristics of Total Edentulism in North Macedonia and Worldwide · 2026 · DOI

• This scoping review aims to identify and map the available evidence, as well as gaps in the literature, relating to oral health improvement and access to care among GRT populations in Europe.

  Dental services access and oral health improvement in Gypsy, Romany and Traveller communities: a scoping review · 2026 · DOI

• Social capital may influence oral frailty, but evidence is limited, particularly regarding individual- and community-level social capital and differences by socioeconomic status (SES).

  Associations between health-related social capital and oral frailty risk among older adults: A stratified analysis by socioeconomic status in the JAGES longitudinal study · 2026 · DOI

• Future research should investigate factors contributing to delays in dental care beyond the COVID-19 pandemic, including caries burden, decayed teeth, and tooth loss, particularly among older adults.

  Trends in Dental Care Visits Across the Lifespan Before and During the COVID-19 Pandemic in the United States: Implications for Practice and Policy · 2026 · DOI

• Perceived oral health status was also significantly associated with clinical tooth decay. Participants who reported good oral Based on the findings of this study, several recommendations can be made to improve oral health knowledge, promote 432 J. J. RUTABANZIBWA AND A. ROSS preventive oral health behaviors, and reduce the burden of untreated dental diseases in Namibia. Firstly, oral health promotion programs should be strengthened and integrated into primary health care services. Education was the strongest predictor of both oral health knowledge and reduced tooth decay, indicating the importance of improving oral health literacy among populations with lower educational attainment. Community-based oral health education campaigns using simple language, visual materials, and local languages should be implemented, particularly targeting disadvantaged and low-literacy populations. Previous studies have shown that improved oral health literacy is associated with better oral hygiene practices, increased utilization of preventive dental services, and improved oral health outcomes [35, 36]. Secondly, oral health education should be incorporated into school health programs and community outreach activities. Early exposure to oral hygiene education may improve lifelong preventive behaviors such as regular toothbrushing and routine dental attendance. Collaboration between the Ministry of Health and Social Services and the Ministry of Education may facilitate the integration of oral health into existing health promotion initiatives. School-based oral health interventions have been shown to significantly improve oral health knowledge and oral hygiene behaviors among children and adolescents [37, 38]. Thirdly, preventive oral health services should be expanded and made more accessible, especially for unemployed and low- income populations. The findings showed that unemployed participants reported higher perceived dental needs, suggesting that financial barriers may limit access to care. Strengthening public oral health services, increasing outreach dental programs, and integrating preventive oral care into existing primary health care packages may help reduce inequalities in access to services. Socioeconomic inequalities in oral health service utilization have been widely reported in both developed and developing countries [20, 39]. Fourthly, there is a need to shift the current oral health system from a predominantly treatment-oriented approach toward prevention and early intervention. Many patients continue to seek care only when symptoms become severe. Public awareness campaigns should therefore emphasize the importance of routine dental check-ups, early treatment, and preventive care to reduce advanced dental disease and tooth loss. Evidence suggests that preventive and early intervention strategies are more cost-effective and contribute to improved long-term oral health outcomes [40]. frequent twice-daily Furthermore, oral hygiene promotion initiatives should toothbrushing with fluoridated encourage toothpaste, as toothbrushing was significantly associated with good perceived oral health. Health care workers, including nurses and community health workers, should be trained to provide basic oral health education during routine patient encounters. The use of fluoridated toothpaste and regular toothbrushing has consistently been associated with reduced dental caries and improved oral hygiene status [41, 42]. Finally, further research is recommended using community- based and longitudinal study designs to better understand causal pathways between socioeconomic factors, oral health perceptions, service utilization, and clinical oral health outcomes in Namibia. Future studies should also explore additional factors such as dietary habits, fluoride exposure, cultural beliefs, and barriers to accessing preventive dental services. Longitudinal and population-based studies are important for informing evidence-based oral health policies and planning [43].

  Perceived importance of oral health among patients attending Katutura Hospital general outpatient department and dental clinic, Namibia · 2026 · DOI

• The Area Deprivation Index (ADI) is a validated measure of neighborhood deprivation, but its association with dental workforce availability has not been examined statewide in California.

  Association Between Area Deprivation and Dental Provider Density in California: A Cross-Sectional Ecological Study · 2026 · DOI

• To our knowledge, the ODR is the first large-scale oral disease registry in Asia established within a national specialty center. Through this, we hope to contribute to the growing literature on real-world oral health research and encourage col- laborations that span registries and health systems. Ongoing work will extend the ODR to include data from other dental specialties (e.g., pediatric dentistry). Incorporation of clinical images and prescription data, as well as natural language processing of free-text notes will enhance data richness and research utility. We hope for the registry to be refreshed at six-month intervals, subject to operational feasibility and resource availability. The ODR's longitudinal structure and linkage potential also position it as a valuable resource for developing and exter- nally validating prognostic models for oral disease outcomes such as tooth loss, an area where existing models have been limited by small sample sizes, inappropriate handling of missing data, and lack of external validation [51]. The utilization of the ODR represents a large-scale effort to integrate electronic oral health records within a major academic medical center in Singapore. This registry provides a valuable platform for research and healthcare service evaluation. Future expansion of its data scope and linkages will further enhance its utility, supporting quality assessment, care improvement, and tar- geted interventions aimed at reducing the burden of oral disease nationally.

  Establishment of a large-scale oral disease registry (NDCS-ODR) in a national specialty center · 2026 · DOI

• Future work will focus on psychometric validation, including interrater reliability and criterion validity against kinematic benchmarks, to confirm the accuracy and repro- ducibility of parent report data. Future research should focus on the reliability of parent-reporting, validating EZ-chEW against kinematic methodologies to establish its accuracy, and examining the clinical utility of the EZ-chEW across diverse populations.

  EZ-chEW: A Pilot Study of a Parental Home Metric for Chewing Performance · 2026 · DOI

• Appendix Future research should focus on expanding the sample size and including subjects trialing a broader range of food con- sistencies to capture a more comprehensive understanding of chewing performance across diverse contexts. Repli- cating previous kinematic studies to quantify jaw motion alongside EZ-chEW parental reports will provide opportu- nities for direct methodological comparisons. Incorporat- ing visual assessments, such as having parents rate videos of their children chewing during kinematic data collection sessions, would allow for a more robust validation of the EZ-chEW tool and strengthen correlations between the two methodologies. Psychometric validation was beyond the scope of this pilot work and is a priority for future research. Feasibility testing and parent feedback are essential next steps before the tool can be recommended for broader use. Further vali- dation should also involve the inclusion of both full-term and preterm children, as well as children with craniofacial anomalies and/or neurologic differences, to explore how these factors influence chewing development and perfor- mance. Correlating EZ-chEW results with other standard- ized measures, such as the Pedi-EAT and ChOMPs, will help establish its reliability and clinical utility across diverse populations. These efforts will not only enhance the validity of the EZ-chEW parental home metric but also contribute to a deeper understanding of the developmental trajectory of chewing performance in early childhood.

  EZ-chEW: A Pilot Study of a Parental Home Metric for Chewing Performance · 2026 · DOI

• A key strength of this study is its specific focus on the general practice setting. The SHORT ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT tool was administered by general practitioners (GPs) or nurse practitioners (NPs).), reflecting the intended real-world context in which the tool is to be used. This ensured that participants, older people attending routine GP visits were representative of the target population. Furthermore, the study included participants from four different general practices with diverse sociodemographic profiles, ranging from socially affluent areas where many older adults still attend dental appointments, to more deprived regions where regular dental care is less common. This variation is reflected in the observed differences in dental attendance and the estimated prevalence of oral health deterioration. The combined sample yielded rates of dental attendance and deterioration of oral health that are consistent with those reported in the literature [8, 22-25]. Another notable strength lies in the comprehensive development and validation process of the SHORT tool. The tool was based on a prior systematic review of the literature and refined through a Delphi consensus study, incorporating expert insights, optimizing item phrasing, and ensuring clinical feasibility. The present validation study built on this foundation by evaluating the tool’s diagnostic accuracy in routine clinical practice. A limitation of the study is that the oral examination was performed by a single examiner, which may have introduced observer bias; ideally, two independent examiners would have been preferable, but this was not feasible in the general practice setting. To mitigate this, the examiner was experienced and worked with a standardized protocol that was discussed with other researchers and dental professionals (Appendix 2). Furthermore, the examination was conducted in general practices without access to dental clinic equipment such as radiographs or a dental chair with overhead light, which may have limited diagnostic detail. ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT Another potential limitation concerns the administration of the SHORT tool itself. It is possible that the degree of professional involvement varied between consultations, potentially influencing how the questions were interpreted or answered. Implications for Practice and Future Research The SHORT tool demonstrated high predictive value and is promising as a screening tool for identifying oral health deterioration and risk thereof in community-dwelling older people within general practice. In practice, the SHORT tool may also provide an opportunity for GPs and practice nurses to raise awareness among edentulous older people that regular oral health care remains relevant, even in the absence of natural dentition. Further research is necessary to assess its implementation in daily practice, as this aspect received only limited attention in the preceding Delphi study and was not evaluated in detail in the current validation study. Although earlier qualitative work highlighted willingness among general practitioners (GPs) and nurse practitioners (NPs) for a brief and easy-to-administer tool, its actual integration into routine practice remains to be explored. Future implementation studies should specifically assess the tool’s acceptability, usability, and feasibility in its finalized three-item format. Understanding how the tool fits into existing workflows and whether it facilitates timely and meaningful referral decisions will be critical for its successful adoption. Beyond the general practice setting, additional research is needed to determine the SHORT tool’s applicability among other healthcare professionals. While GPs and NPs may benefit most from the tool given their time constraints, it also has potential in settings involving pharmacists, home care nurses, or geriatric wards in hospitals. Evaluating its utility and feasibility in these broader contexts could further expand its impact and reach.

  Validating the Short screening Tool pRedicting Oral Health deterioration in older people by the general practitioner (SHORT) in the Netherlands · 2026 · DOI

• The findings of this study highlight the need for targeted policy actions to improve dental-service utilization. The strong association between cost and utilization underscores the importance of integrating dental care into health-insurance schemes and subsidizing essential services to reduce out-of-pocket expenditure. The low uptake of preventive services despite high awareness indicates a need for strengthened oral-health promotion strategies that emphasize behaviour change, particularly through mass media and community-based approaches. Additionally, addressing structural chal- lenges such as long waiting times requires health-system improvements, including better workforce distribution and more efficient service delivery models. Finally, the observed socioeconomic disparities in utilization suggest the need for equity-focused interventions, such as outreach programs and integration of oral health into primary health care, to improve access among underserved populations.

  Barriers to Dental Service Utilization Among Adults in Akure Metropolis, Nigeria: A Cross-Sectional Study · 2026 · DOI

• The literature search included only clinical toothpaste trials that mentioned “fluoride-free” or similar terms in the title or abstract (see Section 2.2 for details), which avoids preselecting specific active ingredients and ensures an objective literature search. On the other hand, studies describing toothpastes solely by their active ingredients without explicitly stating they are fluoride-free could have been overlooked. Furthermore, studies that note the absence of fluoride only in the full text may have been missed. Also, the PRISMA checklist was not followed completely eg. no protocol was prepared in advance. The risk-of-bias analysis was performed only for clinical trials demonstrating caries-preventive efficacy of fluoride-free toothpaste agents, and no meta-analysis was conducted. For meta-analyses on fluoride-free hydroxyapatite toothpastes, we refer to.17 Outlook – New Approaches in Caries Prevention In general, there has been a well-documented improvement and evolution of toothpaste technology.40 Due to the increased global interest in fluoride-free toothpastes, there is a lot of ongoing research in the field of fluoride-free anti- caries agents. Recent clinical trials have analyzed fluoride-free hydroxyapatite toothpastes32,34,39 and fluoride-fee arginine toothpastes37 in the field of caries prevention. Besides these two agents, there are various other promising agents, including calcium compounds such as calcium hypophosphite,58 antimicrobial peptides,59 self-assembling peptides such as P11-4,60 and probiotics.61 These approaches, as well as others, are promising for use in toothpastes and are candidates for further investigation in future clinical trials.

  Fluoride-Free Toothpastes for Caries Prevention: A Systematic Review of Clinical Evidence on Active Ingredients · 2026 · DOI

• This study was constrained by the variables collected in the parent survey. The cross-sectional design precluded causal inference, and current consumption frequency may not reflect historical exposure relevant to cumulative tooth loss. Sugar intake was measured using a simplified frequency category without quantity or timing, which may have introduced nondifferential misclassification and biased associations toward the null. The distribution of both exposure and outcome was imbalanced, with near-universal high-frequency sugar intake and a small proportion in the lowest-retention group, contributing to statistical imprecision. Key determinants such as lifetime dental service use, fluoride exposure, medications, comorbidities, and residence duration were unavailable, leaving potential residual confounding. Because the study included only two sex-segregated facilities, the facility variable captured institutional context rather than biological sex, and within-facility clustering could not be robustly modeled. Future studies that include more institutions, residents with higher dependency levels, and more detailed dietary measures are needed to better characterize pathways from sugar exposure to tooth loss.

  Sugary Snack and Drink Consumption and Tooth Retention Among Residents with Disabilities in Thai Foster Homes: A Cross-Sectional Study · 2026 · DOI

• For Policy and Practice, the following recommendations will guide advocates and policy makers for effective utilization of dental services among the people of Ugwuaji community and the masses at large. 1. Targeted Subsidies: Waive fees for low-income groups like farmers and <₦70,000 (ie the minimum wage). 2. Mobile Clinics: Deploy units to markets/schools prioritizing remote areas to address distance barriers. 3. Community Health Worker (CHW) Integration: Train CHWs in basic dental screening and referral, leveraging high trust scores (4.1/5). 4. Dental Clinics should be attached to the healthcare centres in the community, at least for basic dental needs and care. 5. National Health Insurance Scheme (NHIS) Inclusion: Advocate for mandatory dental coverage in Nigeria’s NHIS.

  Barriers to the Utilization of Government Dental Health Services Among Low-Income Families in Ugwuaji, Enugu South LGA of Enugu State, Nigeria: A Cross-Sectional Survey · 2026 · DOI

• This review provides a comprehensive synthesis of the available evidence on oral health disparities between migrant and non-migrant populations in Germany. A major strength is the inclusion of both quantitative and contextual evidence, allowing clinical findings to be inter- preted alongside structural, social and behavioural deter- minants of oral health. The use of a registered protocol, PRISMA-guided methodology, standardized quality assessment and GRADE evaluation further strengthens the transparency and methodological rigor of the review. Nevertheless, several limitations should be considered when interpreting the findings. Most included studies were observational and predominantly cross-sectional, limiting causal inference. In addition, substantial het- erogeneity existed across studies regarding study popu- lations, definitions of migration background, outcome measures and assessment methods. While some studies used standardized clinical indicators such as DMFT, oth- ers relied partly on self-reported measures, increasing the risk of measurement and recall bias. Selection bias and insufficient reporting of non-response were also common limitations. The certainty of evidence ranged from low to mod- erate across outcomes. Evidence for DMFT scores, missing teeth, periodontal health and dental service uti- lization was generally more consistent and therefore rated as moderate certainty. In contrast, findings related to untreated and filled teeth showed considerable het- erogeneity and were rated with lower certainty. Fur- thermore, migrants were frequently analysed as a single population despite considerable cultural, linguistic and socioeconomic diversity, which may obscure important subgroup-specific differences. Despite these limitations, the evidence consistently indicates that migrant populations in Germany experi- ence poorer oral health outcomes and lower utilization of preventive dental services compared with non-migrants. Future research should prioritize longitudinal and inter- vention-based studies, representative sampling strategies, and standardized outcome reporting to improve compa- rability and strengthen the evidence base.

  Oral health in migrant population of Germany: a systematic review and meta-analysis · 2026 · DOI

• This theory-based digital intervention evaluated both oral health behavior changes and shifts in maternal psychosocial factors, offering explanatory insights into the mechanisms behind behavioral improvements. However, the study had several limitations. First, randomization was not feasible due to COVID-19 pandemic–related constraints that prevented comprehensive implementation of the referral intervention across participating CHCs. The lack of randomization limited our ability to fully account for potential confounders [41]. To mitigate this, we used a parallel group comparison and adjusted for child- and maternal-related confound- ing variables, strengthening causal inference. Second, the COVID-19 pandemic prevented clinical assessments of oral health outcomes (eg, caries incidence), restricting our analysis to rely on self-reported behaviors, which might introduce reporting bias. Future studies can more comprehensively assess the effect of theory-based digital interventions on children’s oral health.

  A Theory-Based Digital Intervention to Improve Maternal Oral Health Behaviors for Young Children: Quasi-Experimental Study. · 2026 · DOI

• the development of standardized diagnostic thresholds, improved calibration protocols, and consistent reference standards to reduce heterogeneity across studies. Longitudinal investigations evaluating lesion progression and treatment outcomes are also needed to determine the clinical impact of fluorescence-based detection technologies. Additionally, well-designed comparative studies assessing newer fluorescence devices under standardized clinical conditions would further clarify their role in pediatric caries management.

  Comparative diagnostic accuracy of laser fluorescence and conventional caries detection methods in children: a systematic review and meta analysis · 2026 · DOI

• Looking ahead, a clear trend in Chile is the ageing population. Currently, Chile is considered to be a country with “advanced ageing” and it is expected that by the year 2030 it will have the highest ageing index in the region, reaching a proportion of older people close to 28% by 2050, that is, approximately one in four people will be over 60 years of age (76). Parallel to this, there is also evidence of an epidemiological transition in oral health, moving from high rates of edentulism and tooth loss towards lower rates of edentulism and general improvement of oral health in the older population (77, 78). This creates new challenges to society and, more specifically, to the dental profession. For example, how to maintain the oral health of that group of the population. This confluence of public health trends raises the prospect that the cost-saving benefits of CWF might be offset to some degree by the potentially high costs of periodontal treatment needs later in life (79). The increased oral health needs of older Chileans, and the difficulties in providing access to proper oral health services in RACFs, will become a challenge for the entire society and, in particular, for oral health professionals. Fluoride is widely acknowledged as an in children. Its effective protection against coronal caries efficacy in older adults and in preventing root caries, however, is more limited (9). In Chile, within the normative framework that regulates the health authorization of RACFs, the application of oral hygiene and fluoride exposure protocols and oral health aspects are not specifically contemplated (80), so oral care practices performed or supervised in the respective RACFs are unknown (81). Silver Diamine Fluoride (SDF) has emerged as an innovative treatment option for managing dental caries, especially in young children and individuals with limited access to dental care. In Chile (SDF) is recognized as an effective and minimally invasive treatment for dental caries, particularly for early childhood caries and in managing older adults with sensitive teeth and/or root caries (82, 83). While SDF is being integrated into the curriculum of Chilean dental schools, it is not included in a widespread national government program like “Sembrando Sonrisas”; which currently focuses on toothbrushing and fluoride varnish (84, 85). This suggests its use is primarily in private or academic settings. This effort will not only help to increase information about preventing and management root caries lesions of dentate older adults and in so doing, decrease disadvantages in oral health and help them maintain high levels of general health, quality of life, nutrition, and social interactions. Given that SDF is an affordable, portable, and effective alternative to traditional restorative treatments, especially for underserved communities, its future use is likely to expand (86, 87). Global health policies are increasingly promoting SDF for caries control, and its cost-effectiveness makes it a strong candidate for inclusion in public health programs to improve oral health equity in Chile and other countries (86, 88). The future of fluoridation programs in Chile will likely involve integrating new technologies and delivery methods, such as mobile health applications, to inform and educate communities and monitor fluoride levels (89). Additionally, continued investment in research and community education will be essential for dispelling myths and fostering trust in fluoridation initiatives. A multidisciplinary approach is needed to address existing challenges and enhance public acceptance of initiatives to improve dental public health through both preventive measures and economic incentives (e.g., fluorides and sugar tax). Furthermore, exploring alternative delivery methods, such as the integration of fluoride into dietary supplements or expanded access to dental care, may enhance the effectiveness of public health strategies. Collaborative efforts with international health organizations can also provide valuable insights and resources for optimizing fluoridation programs.

  Fluoridation in Chile: historical context, current programs, challenges, and future directions · 2026 · DOI

• for fluoridation The manuscript contributes to the existing literature by improving the understanding of fluoridation programs in Chile, a country where oral health disparities persist despite various public health initiatives. By examining diverse delivery methods and emphasizing the need for community engagement, the review highlights the complexities of implementing effective oral health strategies.

  Fluoridation in Chile: historical context, current programs, challenges, and future directions · 2026 · DOI

• improve learning the to institution Several methodological limitations of this pilot study warrant explicit acknowledgment. First, the small sample size of 70 participants recruited limits the from a single generalizability of the findings to broader populations. Second, image acquisition was restricted to mandibular occlusal and labial surfaces, limiting the representativeness of the dataset with respect to the full intraoral dentition. Third, ground-truth labels were based exclusively on expert visual assessment of smartphone photographs without an independent clinical reference standard, introducing inherent uncertainty particularly for early-stage lesions. This limitation is especially relevant for Initial-1 classification, as ICDAS code 1 lesions require airdrying under visual detection — conditions that could not be replicated in the selfacquired imaging setting of this study. Fourth, the pronounced class imbalance, with sound surfaces comprising more than 80% of all instances, limited stable learning for minority caries categories and may have inflated aggregate metrics.

  Feasibility of multi-class dental caries detection using deep learning–based smartphone images: a pilot prospective study · 2026 · DOI

• The mechanistic roles of calcium, phosphate, and trace ions (fluoride, zinc, magnesium, silanols) in fostering enzymatic protection, pH buffering, and microbial modulation within hybrid layers require controlled long-term randomised clinical trials to establish whether these biological mechanisms translate to superior clinical performance in selective caries removal.

  Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment · 2026 · DOI

• Diagnostic innovations such as fluorescent intraoral cameras demonstrate clinical benefits in caries detection but historically receive only moderate evidence ratings; standardised comparative studies are needed to establish their diagnostic accuracy and clinical value relative to conventional detection methods in minimum intervention dentistry.

  Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment · 2026 · DOI

• Integration of AI-assisted material selection with 3D printing and bioprinting technologies for producing patient-specific bioactive restorations requires validation studies measuring clinical outcomes in deep caries management with liners and dentin substitutes under selective caries removal protocols.

  Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment · 2026 · DOI

• The clinical efficacy and long-term performance of recently developed chemically cured restorative systems and next-generation fluorinated varnishes remain poorly documented; these materials lack sufficient volume of long-term randomised evidence despite demonstrating encouraging early mechanistic data for dentin remineralisation and hybrid layer stabilisation.

  Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment · 2026 · DOI

• Long-term randomised clinical trials comparing ion-releasing bioactive restorative materials (calcium, phosphate, fluoride, zinc, magnesium, silanols) are needed to test superiority in clinical outcomes such as tooth survival, secondary caries incidence, postoperative hypersensitivity, and restoration longevity using S3-level evidence-based guideline methodology.

  Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment · 2026 · DOI

Most-cited papers in Dental Health and Care Utilization

• Development of the Geriatric Oral Health Assessment Index · Journal of Dental Education · 1990 · 832 citations
• Global epidemiology of dental caries and severe periodontitis – a comprehensive review · Journal Of Clinical Periodontology · 2017 · 738 citations
• Disparities in Access to Oral Health Care · Annual Review of Public Health · 2020 · 434 citations
• What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? · Clinical Oral Implants Research · 2007 · 374 citations
• The global prevalence of early childhood caries: A systematic review with meta‐analysis using the WHO diagnostic criteria · International Journal of Paediatric Dentistry · 2021 · 340 citations
• PUFA – An index of clinical consequences of untreated dental caries · Community Dentistry And Oral Epidemiology · 2009 · 325 citations
• <scp>WHO</scp>'s global oral health status report 2022: Actions, discussion and implementation · Oral Diseases · 2023 · 300 citations
• Association between oral health and frailty: A systematic review of longitudinal studies · Gerodontology · 2019 · 288 citations
• Impact of traumatic injuries to the permanent teeth on the oral health‐related quality of life in 12–14‐year‐old children · Community Dentistry And Oral Epidemiology · 2002 · 270 citations
• Relationship between oral health literacy and oral health status · BMC Oral Health · 2018 · 230 citations

Most recent work

• Oral Health-Related Quality of Life Determinants in the Elderly from a Costa Rican Day Center: Findings of a Pilot Study · Odovtos - International Journal of Dental Sciences · 2026
• Barriers and facilitators in utilisation of dental health services across low- and middle-income countries: a scoping review · Evidence-Based Dentistry · 2026
• Impact of Impaired Fasting or Diabetes Compared with That of Smoking Habit on Tooth Loss · The Bulletin of Tokyo Dental College · 2026
• The Use of Puppetry‐Based Approaches in Dental and Oral Health Promotion for Children: A Scoping Review of Interventions · International Journal of Paediatric Dentistry · 2026
• Effect of Oral and Prosthodontic Rehabilitation on Nutrition and General Health Outcomes in Edentulous Elderly Populations: A Systematic Review · International Journal of Dentistry · 2026
• Impact of resin infiltration on self-reported bullying and OHRQoL in children with MIH: a single-arm clinical trial · European Archives of Paediatric Dentistry · 2026
• Projected Oral Health Outcomes and Costs Associated With Pediatric Medicaid Disenrollment · JAMA Network Open · 2026
• Coronal and Root Caries in Older Adults: Associated Factors, Quality of Life Impact, and Treatment—A Scoping Review · Gerodontology · 2026
• Remineralization of early caries lesions by calcium hypophosphite in vitro: a surface microhardness study · BDJ Open · 2026
• Grading in Gerodontology: A Framework · Gerodontology · 2026

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