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Necessity and Influencing Factors for Integrating Oral Health in Cancer Care for Older People: A Narrative Review

Shalya Anand, Anita Visser, Joel B. Epstein, Djenana Jalovcic Apr 1, 2026 6 views 9 min read
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Necessity and Influencing Factors for Integrating Oral Health in Cancer Care for Older People

Abstract

As the global population ages, the number of older adults diagnosed with cancer and experiencing poor oral health is increasing rapidly. This narrative review examines the need for integrating oral healthcare into cancer care pathways for older adults. The study highlights the impact of cancer therapies on oral health, the benefits of oral healthcare integration, and key influencing factors such as oral health literacy, interprofessional collaboration, workforce capacity, financial barriers, and health equity. The review concludes with actionable recommendations to strengthen the integration of oral healthcare into comprehensive cancer care for older adults.

Introduction

The global population is ageing rapidly, with older adults expected to constitute a significant proportion of the world's population by 2050. At the same time, cancer incidence continues to rise among older adults, making comprehensive and patient-centered care increasingly important. Oral health plays a critical role in overall health, nutrition, communication, social interaction, and quality of life. However, oral healthcare remains largely overlooked in cancer care pathways, particularly for older adults undergoing treatment for cancers other than head and neck cancers.

Cancer therapies such as chemotherapy, radiotherapy, stem cell transplantation, targeted therapies, and immunotherapies can cause significant oral complications including mucositis, xerostomia, oral infections, oral pain, dysphagia, and impaired chewing ability. These complications can negatively affect nutrition, treatment adherence, recovery outcomes, and overall wellbeing. Despite the strong connection between oral health and cancer treatment outcomes, oral healthcare professionals are often excluded from multidisciplinary oncology teams.

Purpose of the Review

This narrative review explores the necessity of integrating oral healthcare into cancer care for older adults. It examines the impact of oral health on cancer treatment outcomes, identifies barriers to integration, and highlights opportunities for improving patient care through interdisciplinary collaboration.

Oral Health Challenges in Older Adults with Cancer

  • Increased risk of oral diseases due to ageing, comorbidities, and polypharmacy.
  • Higher prevalence of oral frailty, tooth loss, periodontal disease, and dry mouth.
  • Cancer therapies frequently exacerbate existing oral health conditions.
  • Oral complications may contribute to malnutrition, infection, pain, and reduced quality of life.
  • Poor oral health can negatively affect cancer treatment outcomes and survivorship.

The Importance of Integrating Oral Healthcare

Research demonstrates that early oral health assessment, preventive care, and regular dental follow-up can significantly reduce treatment-related complications. Integrating oral healthcare into oncology pathways supports better treatment adherence, improved nutrition, reduced hospitalizations, and enhanced patient wellbeing.

Recommended interventions include oral health screening before cancer treatment, professional oral hygiene care, patient education, caregiver support, and ongoing monitoring throughout the treatment journey.

Key Factors Influencing Integration

1

Oral Health Literacy

Limited awareness among patients and caregivers often results in delayed oral care and inadequate oral hygiene practices. Improving oral health literacy can empower individuals to take preventive measures and seek timely professional care.

2

Interprofessional Collaboration

Successful integration requires collaboration between oncologists, geriatricians, nurses, dentists, and other healthcare professionals. Current healthcare systems often operate in silos, limiting coordinated care and reducing opportunities for early intervention.

3

Workforce Capacity

There is a shortage of oral healthcare professionals trained in geriatric oncology. Expanding education and specialized training programs can strengthen the workforce and improve access to care.

4

Financial Barriers

Many older adults face significant out-of-pocket expenses for dental treatment. Limited insurance coverage and inadequate public funding contribute to delayed or neglected oral healthcare.

5

Ageism and Health Inequities

Older adults often experience disparities in healthcare access and decision-making. Recognizing oral health as a fundamental component of healthy ageing is essential for reducing inequities and improving outcomes.

Recommendations

  • Include oral health assessments in routine oncology care.
  • Develop interdisciplinary clinical practice guidelines.
  • Promote oral health literacy among patients and caregivers.
  • Strengthen collaboration between dental and medical professionals.
  • Expand workforce training in geriatric oral healthcare.
  • Support policies that improve affordability and access to oral healthcare services.
  • Leverage digital health technologies, telehealth, and artificial intelligence to improve screening and care coordination.

Conclusion

The integration of oral healthcare into cancer care is essential for improving treatment outcomes, quality of life, and overall wellbeing among older adults. Evidence shows that proactive oral health management can reduce complications, support treatment adherence, and promote healthy ageing. Greater collaboration between healthcare disciplines, improved oral health literacy, and supportive policy frameworks are necessary to ensure that oral healthcare becomes an integral component of comprehensive cancer care.

Methodology

A narrative review was conducted using MEDLINE, CINAHL, PubMed, Scopus, and Web of Science databases. Literature published between 2012 and 2023 was reviewed to identify evidence relating to oral health, cancer treatment outcomes, integrated care models, and healthcare needs of older adults with cancer.

Key Findings

  • Cancer therapies frequently result in oral complications including mucositis, xerostomia, infections, oral pain, and dysphagia.
  • Poor oral health negatively affects nutrition, treatment compliance, and quality of life.
  • Integration of oral healthcare improves treatment outcomes and survivorship.
  • Oral health literacy among patients and caregivers remains limited.
  • Interprofessional collaboration between dental and oncology teams is insufficient.
  • Financial barriers and workforce shortages limit access to oral healthcare.

Conclusion Recap

Integrating oral healthcare into cancer care is essential for improving the overall well-being, treatment outcomes, and quality of life of older adults with cancer. Despite strong evidence supporting integration, oral healthcare remains largely absent from multidisciplinary cancer care pathways outside of head and neck oncology.

Recommendations Summary

  • Incorporate oral health assessments into routine cancer care.
  • Establish interdisciplinary collaboration between oncology and dental professionals.
  • Improve oral health literacy among patients and caregivers.
  • Develop clinical guidelines for oral healthcare in geriatric oncology.
  • Expand workforce training in gerodontology and oncology-related oral healthcare.
  • Support policy reforms that improve access to preventive oral healthcare services.

Impact

The research demonstrates that integrating oral healthcare into cancer care can reduce complications, improve treatment outcomes, support healthy ageing, and enhance the quality of life of older adults undergoing cancer treatment.