Mapping oral-systemic health relationships: a data-driven analysis of co-occurrence patterns in biomedical literature

To systematically map co-occurrence patterns between systemic medical conditions and oral diseases in the biomedical literature.

We conducted a large-scale bibliometric analysis of PubMed-indexed literature from 1995 to 2025. Using automated Application Programming Interface queries, we retrieved publications jointly referencing 256 systemic conditions (defined using the Agency for Healthcare Research and Quality's Clinical Classifications Software) and 5 oral health conditions (periodontal disease, dental caries, tooth loss, oral ulcers, and oral cancers). Search strategies combined Medical Subject Headings and title/abstract terms. Co-occurrence data were normalized using max scaling and analyzed using hierarchical clustering, K-means clustering, and network visualizations. This study reports associations between conditions and not causal relationships.

The search identified 79 817 co-mention instances across 39 782 unique publications. Of 256 medical conditions, 237 co-occurred with at least one oral condition. Periodontal diseases and oral cancers accounted for the largest share of co-mentions (42 554 and 38 735, respectively). Hierarchical clustering of systemic conditions revealed eight clusters, including malignancies strongly co-occurring with oral cancers and immunity disorders co-occurring with periodontal diseases. Dental conditions grouped into three clusters: (1) caries, ulcers, and tooth loss; (2) oral cancers; and (3) periodontal diseases. Publication-level clustering identified 6 thematic domains dominated by oncology and inflammation research.

This study provides a data-driven overview of oral-systemic health research across three decades, highlighting well-studied co-occurrence patterns, such as periodontal-diabetes, oral cancer-malignancies and less frequently represented areas involving caries, ulcers, and tooth loss, underscoring opportunities for interdisciplinary research and integrated care models.