Breaking the silos: a systematic review of oral health integration strategies for improved oral health and cardiovascular outcomes

Background: Poor oral health is associated with cardiovascular diseases (CVDs), largely due to shared risk factors such as smoking, diabetes and socioeconomic disadvantage. Integrating oral health into primary and specialist care, particularly cardiac services, presents a promising strategy to improve early detection of oral diseases and related health outcomes. This systematic review examines oral health strategies implemented in primary and cardiovascular care settings, focusing on their impact on oral and CVD indicators, service delivery and medical-dental collaboration. Methods: A systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and reported following PRISMA 2020 guidelines, with the protocol registered in PROSPERO. Peer-reviewed studies were systematically searched across major databases. Guided by the PICO framework, data were extracted on populations, interventions, settings and outcomes. Study quality was assessed using JBI and Mixed Methods Appraisal Tool criteria, and findings were synthesised using narrative and thematic analysis. Results: Evidence from 17 studies highlight key integration strategies: (1) medical-dental collaboration through interdisciplinary care and co-location; (2) implementing oral health screening in non-dental settings; (3) non-dental teams providing oral health education and preventive care and (4) upskilling non-dental providers. Reported outcomes included improved oral health access, earlier detection of oral disease, enhanced provider confidence, increased chronic disease screening in dental settings and improved CVD markers. Conclusion: Integrated care models can bridge the oral-CVD care divide, improving equity and outcomes. However, sustainable implementation will require policy support, workforce training and evaluation of long-term cost-effectiveness and impact. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251113478, PROSPERO CRD420251113478.