The Oral-Systemic Nexus in Pandemics: A Review of Interprofessional Management of Oral Manifestations and Drug-Related Osteonecrosis in Immunocompromised Patients
Abstract
Background: The oral cavity is a critical, yet often overlooked, sentinel site in systemic disease and a source of significant morbidity in immunocompromised patients, including those with HIV/AIDS, cancer, and organ transplants. Pandemics and outbreaks exacerbate these vulnerabilities, straining healthcare systems and fragmenting care pathways that are already complex. Oral manifestations like ulcerative mucositis and drug-related osteonecrosis of the jaw (MRONJ) represent challenging intersections of infectious disease, pharmacology, and immunosuppression, demanding high levels of interprofessional coordination.
Aim: This narrative review aims to examine the distinct and collaborative roles of dentistry, pharmacy, nursing, medical laboratories, medical secretaries, and health management, framing the integration of oral health within broader health security and systems resilience frameworks.
Methods: A comprehensive search of PubMed, Scopus, CINAHL, and Web of Science databases (2010-2024) was conducted. Literature was analyzed thematically to map care pathways and identify systemic barriers and facilitators to integrated care.
Results: The review identifies significant gaps in interprofessional communication and standardized care pathways for oral-systemic conditions. Key findings include the critical role of nursing in early oral assessment, the necessity of pharmacist-led medication review to mitigate MRONJ risk, and the systemic failures that occur without proactive coordination by health management and medical secretaries.
Conclusion: Effective management of the oral-systemic nexus in pandemics requires deliberately designed, interprofessional care models. Integrating oral health into primary care protocols for vulnerable populations, empowering non-dental professionals in oral screening, and formalizing communication channels are essential for building resilient health systems that can maintain comprehensive care during crises.
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Copyright (c) 2024 Mahdi Atallah Aljohani, Mohsen Sameer Alhaddad, Nora Abkar Ahmed Fulayhi, Sitah Ahmed Hadi Hakami, Jamilah Hbailees Alqahtani, Maha Sultan Majed Alotaibi, Mamdouh Sharar Alotaibi, Ahmed Hasan Alosami, Warda Fahad Alharbi, Mustafa Ibrahim Maes, Zahra Mohammed Ali Kriri, Ali Ahmed Mohammed Asiri
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