The Frontline Sentinel System: A Review of Nursing and Health Assistant Oral Assessments in Early Detection of Systemic Disease and Nutritional Risk
Abstract
Background: The oral cavity is a vital diagnostic tool for systemic health, revealing issues related to diabetes, HIV, nutritional deficiencies, and cancers. However, thorough oral assessments are not consistently performed by non-dental professionals. Nursing and Health Assistant staff, who have excellent patient access, often lack the necessary training and protocols for effective oral pathology screening, leading to a significant gap in holistic patient care.
Aim: This narrative review aims to synthesize and critically evaluate the evidence supporting structured oral assessments by Nursing and HA staff as a frontline sentinel system.
Methods: A comprehensive search of PubMed, CINAHL, Scopus, and Web of Science (2010-2024) was conducted. Literature was analyzed thematically to evaluate assessment tools, training outcomes, referral efficacy, and impact on patient care and system resilience.
Results: The review highlights that validated tools like the Oral Health Assessment Tool (OHAT) demonstrate reliability when utilized by trained non-dental personnel. Effective programs involve concise training and integrated clinical pathways. However, issues such as fragmented workflows, poor interprofessional communication, and lack of institutional policies impede widespread adoption. When implemented, these systems enhance early detection, enable timely interventions, and minimize severe complications.
Conclusion: Empowering nursing and healthcare staff as oral health sentinels is an effective and cost-efficient intervention that significantly impacts patient outcomes and healthcare resilience. Successful implementation necessitates institutional commitment to interprofessional education, incorporation into electronic health records, and establishing clear referral protocols. This approach emphasizes oral health as essential to proactive healthcare and health security.
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Authors
Copyright (c) 2025 Latifa Mubarak Maghram Al-Ghamdi, Hussam Atiah Domari, Abualqasim Abdullah Masmali, Wafaa Mohammad Modarba, Alanoud Abduallh Alhulayyil, Hessa Trad Alonzay, Asrar Abdulrahman Hezam Abed, Shrouq Ibrahim Al-Rahili, Maha Turki Sulayhim Alshammari, Falah Mulfi Salman Alsharari, Tariq Ghalib Alharbi, Fareed Muadhid Munahi Alotaibi

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