Tehran University of Medical Sciences

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Feasibility Assessment of Integrated Oral Health Care Pathways Designed for Pediatric and Adult Patients Referred to School of Dentistry Publisher Pubmed

Summary: Can a preventive approach improve oral health? Research suggests Integrated Oral Health Care Pathways enhance tooth-brushing and care delivery. What can long-term studies reveal? #OralHealth #PreventionScience

Hashemi T M ; Khami M R ; Razeghi S ; Yazdani R ; Shirvani A ; Gholami M
Authors

Source: BMC Oral Health Published:2026


Abstract

Introduction: Transitioning from a treatment-oriented model to a prevention-focused approach is essential for improving oral health outcomes. This study aimed to assess the feasibility and implementation outcomes of Integrated Oral Health Care Pathways (IOHCPs) for pediatric and adult patients referred to a dental school setting. Methods: A four-month mixed-methods feasibility study was conducted at the School of Dentistry, Tehran University of Medical Sciences. IOHCPs were implemented for pediatric and adult patients using risk-based preventive care, oral health education, and structured follow-up. Participants were allocated into three groups (control, routine care, and IOHCP intervention). The study followed the Donabedian framework (structure, process, and outcomes). Clinical outcomes (OHI-S, DMFT, and bleeding on probing [BOP]) and behavioral indicators were assessed. Process indicators were evaluated between routine care and IOHCP groups. Semi-structured interviews were conducted to assess structural feasibility. Statistical analyses included trend tests, chi-square tests, and independent t-tests, with a significance level of 0.05. Results: A total of 780 patients (420 adults and 360 children) were included. OHI-S showed a significant improvement across groups in both adults (2.75 to 1.88) and children (2.29 to 1.25; p < 0.001). Behavioral indicators demonstrated favorable trends in the IOHCP group, including increased tooth brushing frequency and higher preventive care uptake (p < 0.001). Process indicators showed marked improvement in the delivery of preventive services in the IOHCP group compared to routine care (p < 0.001). DMFT increased in adults over time, reflecting cumulative disease experience, while no significant change was observed in children. Differences in BOP between routine care and IOHCP groups were not statistically significant. Conclusion: The implementation of Integrated Oral Health Care Pathways in a dental educational setting was feasible and acceptable. The pathways improved preventive care delivery processes and were associated with favorable oral hygiene behaviors. However, changes in clinical disease indicators were limited within the short study period. Further long-term studies are needed to evaluate sustainability and clinical impact. © The Author(s) 2026.