Integrating Oral Health into Pandemic Preparedness and Response: Missed Opportunities and Strategic Imperatives for Global Health System Resilience and Security

The COVID-19 pandemic exposed a critical vulnerability in global health security: the systematic exclusion of oral health from emergency response frameworks. Despite evidence linking oral health to severe COVID-19 outcomes and its potential for disease surveillance, oral health was largely sidelined during the crisis. The primary purpose of this research project is to address this gap by: Assessing Global Integration: Evaluating the extent to which oral health was represented in national COVID-19 taskforces and funding mechanisms. Identifying Barriers: Pinpointing policy-level obstacles, such as the classification of oral care as "non-essential" and its omission from the International Health Regulations (IHR). Synthesizing Lessons: Distilling evidence from successful service adaptations (e.g., teledentistry) and workforce mobilization strategies used during the pandemic. Providing Strategic Imperatives: Developing a framework for integrating oral health into future Pandemic Preparedness and Response (PPR) planning to enhance health system resilience. Methodology Overview This study is a scoping review conducted according to the PRISMA-ScR guidelines. It synthesized evidence from 26 eligible studies identified through systematic searches of PubMed/MEDLINE and Scopus for the period 2000–2025. Data were charted and analyzed using the WHO Health System Building Blocks framework, covering governance, financing, workforce, service delivery, information systems, and medical products. Expected Outcomes The research aims to transform the long-standing oversight of oral health into a strategic asset for global health security. Key expected outcomes include: Policy Recommendations: Proposing the formal integration of oral health into international instruments like the WHO Pandemic Agreement and the IHR. Operational Frameworks: Providing evidence-based strategies for mobilizing oral health professionals (OHPs) in roles such as vaccination, testing, and syndromic surveillance during future emergencies. Systemic Reform: Advocating for "One Health" governance that bridges the gap between oral and general health systems to prevent the "non-essential" care designation from hindering access in future crises. Resilience Building: Institutionalizing innovations like teledentistry and robust infection control protocols within national PPR plans to ensure the continuity of essential care.