Integrating Oral Health Into Occupational Therapy: Knowledge, Practices, Barriers and Facilitators-A Systematic Review.

Background: Oral health is essential for overall wellbeing and daily functioning, yet its integration into occupational therapy remains limited. Despite the profession's potential to promote oral health through person-centred, occupation-based approaches, evidence of this integration is scarce. This systematic review explores occupational therapists' (OTs) knowledge and practices in oral health care and examines the barriers and facilitators to incorporating oral health care into their clinical practice. Methods: A comprehensive search was conducted across four databases: MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS and EMBASE (Ovid). Studies were deemed eligible if they reported on OTs' knowledge and practices, as well as the barriers and facilitators to incorporating oral health into clinical practice. Two reviewers independently screened studies, extracted data and resolved discrepancies through team consultation. We assessed methodological quality using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. We performed thematic analysis and reported the results in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Of the 14,138 records screened, three qualitative studies met the inclusion criteria. While these studies highlighted OTs' recognition of oral health's impact on daily living and their awareness of person-related challenges to oral hygiene, the relatively small number of included studies limits the generalisability of these findings. Reported practices included assessment, education, environmental modifications, and sensory strategies. Facilitators included prior therapist training, family-centred care and access to resources for oral health intervention. Barriers included limited oral health knowledge, insufficient training, systemic service gaps, lack of oral healthcare supplies and other resource constraints. Conclusion: This review suggests preliminary insights that OTs could potentially play a meaningful role in promoting oral health but are constrained by barriers at individual, organisational and systemic levels. Strengthening workforce training, interprofessional collaboration and policy support may help address oral health needs within occupational therapy practice.