Integrating oral health screening into general practice: validation study of the Oral Health Screener

Oral health in older adults is often poor, with a high prevalence of caries, periodontal disease, and tooth loss. As dental care utilization declines with age, while contact with general practitioners (GPs) increases, GPs could play an important role in preventive oral care, by detecting oral care needs and initiating preventive actions. To compare oral health assessment outcomes between GP trainees (GPTs) and dentists (benchmark), 58 adults aged 65 years or older were independently assessed by GPTs and dentists on the same day using the nine-item Oral Health Screener (OHS), covering both self-reported and observational items. Percent agreement, kappa statistics, and generalized linear mixed models (GLMM) were used to assess inter-rater reliability. GPTs showed high agreement with dentists for self-reported items (89.7-94.8%; kappa: 0.75-0.96; GLMM correlations with covariate adjustment: 0.93-1.00), moderate to strong agreement for denture hygiene assessment (88.2%; κ = 0.72; corr.=0.87) and gum condition (84.5%; κ = 0.57; corr.=0.87), but low agreement for observational items including teeth (69.1%; κ = 0.29; corr.=0.58), tongue (84.5%; κ = 0.23; corr.=0.26), soft tissues (75.9%; κ = 0.15; corr.=0.15), and oral hygiene (61.4%; κ = 0.21; corr.=0.18). These findings indicate that GPTs can reliably assess patient-reported oral health items but show substantial variability in evaluating clinical signs. These findings highlight the potential of GPs to identify oral health problems while underscoring the need for targeted training to enhance their observational skills.