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Integration of Endodontic Services Into Preventive Oral Health Care: A Narrative Review
Chitharanjan M Shetty1, Derek Shaji Pious1, Maria Anna Geevarghis1
1Department of Conservative Dentistry and Endodontics, A. B. Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, 575018, Karnataka, India, nitte.edu.in.
Background:
The integration of endodontic services into preventive oral health care has become increasingly important as dental caries and pulpal pathologies remain major contributors to the global burden of oral disease. However, despite advances in preventive dentistry, gaps persist in the early identification and management of pulpal disease within primary care systems. Integrating endodontic services may enhance early diagnosis, timely intervention, and long-term tooth preservation.
Methods:
A narrative review of published literature was conducted to examine current models, strategies, and evidence related to integrating endodontic care within preventive oral health frameworks. Key databases and professional organizational documents were reviewed to identify themes including service delivery models, workforce considerations, recent technological advances, barriers, and policy directions. Methodological rigor was enhanced using structured narrative review approaches and guided thematic synthesis.
Results:
Evidence indicates that integration enhances continuity of care, improves access to early pulp therapy, and reduces disease progression. Successful models include referral-based coordination, colocation of care, and deployment of practitioners with enhanced endodontic skills. Technological developments such as digital diagnostics, artificial intelligence, and minimally invasive endodontic techniques further support integration. However, barriers such as fragmented health systems, limited workforce capacity, inconsistent funding, and inadequate training persist. Importantly, the current evidence base remains heterogeneous, with limited long-term outcome data and variability in implementation across health systems. Policy frameworks and interprofessional collaboration are essential to overcoming these challenges.
Conclusion:
Integrating endodontic services into preventive oral health systems is feasible and beneficial, offering improved patient outcomes and stronger primary care delivery. Adoption of standardized referral pathways, workforce development, digital infrastructure, and supportive policies can facilitate broader implementation. Future research should prioritize cost-effectiveness analyses, standardized outcome measures, and evaluation of long-term clinical impact to support scalable integration models.
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