Abstract
Abstract
Introduction
Oral health research provides evidence for policy and practice, yet no study has comprehensively mapped the scope of oral health research in Malaysia. The COVID-19 pandemic has also created a great impact on oral healthcare in Malaysia, including the dental care delivery. Additionally, there is a notable lack of research focusing on oral health during and after the COVID-19 pandemic. Therefore, this scoping review will aim to map the landscape of oral health research conducted in Malaysia and identify key topics, study designs, populations studied and gaps in the literature, in order to inform future research priorities and policy, particularly in the post-COVID-19 era.
Methods and analysis
The methodology draws on Arksey and O’Malleys’ seminal framework for the scoping review and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines. We will search five major electronic databases—PubMed, Scopus, ProQuest, Cochrane and Web of Science—as well as selected grey literature sources (eg, theses, dissertations and conference proceedings) for studies published in English from January 2014 to December 2024. Studies of any design related to oral health in Malaysia will be included. Two reviewers will be performing title and abstract screening, in which they will be working independently. The included publication will undergo a full-text review, and references cited in these studies will be examined following the inclusion criteria. The PRISMA-ScR flow diagram will be used as a guide throughout the process. Data will be extracted, analysed and charted according to key categories identified in the included publications. A narrative synthesis and descriptive statistics will be presented.
Ethics and dissemination
The results of this scoping review will illustrate an overview and provide a better understanding regarding the oral health research in the Malaysian context; whether research has already been conducted, is currently ongoing and is still needed; and which areas should be prioritised for future investigation. As this review will use publicly available literature, formal ethics approval will not be required. The findings will be submitted for publication in an open-access peer-reviewed journal, presented at national and regional conferences and shared with Malaysian dental professional bodies and relevant stakeholders.
Trial registration number
The protocol of this scoping review is registered with the Open Science Framework and is available at osf.io/hjq6m.
Keywords: Review, ORAL & MAXILLOFACIAL SURGERY, Paediatric oral & maxillofacial surgery, Dentistry
STRENGTHS AND LIMITATIONS OF THIS STUDY.
This review will be the first to comprehensively map oral health research in Malaysia and examine the impact of the COVID-19 pandemic on this field, drawing from both peer-reviewed and grey literature.
Restricting the review to English publications may exclude some local-language studies.
Introduction
Oral health refers to the condition of the mouth, teeth and orofacial structures that enables essential functions like eating, speaking and breathing. It also includes psychosocial aspects such as self-confidence, well-being and the ability to live without pain or embarrassment. Oral health is vital throughout life, contributes to overall health and supports individuals in fully participating in society and reaching their potential.1 It is not only a marker of overall health but is also closely linked to quality of life. Maintaining optimal oral health is crucial for preventing conditions that can damage the hard and soft tissues of the mouth that may lead to difficulties in biting, chewing, smiling, speaking and overall aesthetics.2 Additionally, poor oral health has been associated with negative psychosocial outcomes, reduced employability and a detrimental impact on physical fitness and performance.3 As such, the preservation of oral health is integral to achieving overall well-being.
Globally, oral diseases remain a significant public health issue, with an estimated 3.5 billion people affected. Approximately 2.3 billion individuals suffer from caries of permanent teeth, while over 530 million children experience caries in primary teeth.4 Severe periodontal disease impacts around 10% of the global population, and nearly 20% face oro-dental trauma during their lifetime.5 In Malaysia, the burden of oral diseases mirrors the global trends. Oral diseases remain a major public health concern, particularly dental caries and periodontal disease. The National Oral Health Survey of Adults (2010) reported that 88.9% of adults had dental caries, and 94% experienced periodontal conditions.6 Among children, 71.3% were affected by dental caries, with a reduction in caries prevalence among 5 year-olds from 87.1% in 1995 to 71.3% in 2015; however, the mean severity of the condition remains a concern.7 Furthermore, the National Health and Morbidity Survey 2019 highlighted an increasing burden of acute oral health issues over the past 5 years.8 Notably, oral cancer ranks among the top 20 most common cancers in Malaysia, with projections indicating that incidence rates may double by 2040.9
Recognising the importance of addressing oral health issues, the Ministry of Health Malaysia has prioritised oral health research in its Health Research Priorities for the 12th Malaysia Plan (12MP-HRP) 2021–2025. This strategic document emphasises the need for research in key areas such as oral diseases, access to dental services, oral cancer and the integration of digital technologies in dental healthcare.10 The National Oral Health Policy further underscores the role of research in shaping evidence-based approaches for patient care, as well as guiding the development and evaluation of public health programmes.11
However, oral health encompasses many dimensions, and a scoping review may reveal areas beyond those emphasised in the 12MP-HRP that remain underexplored. This will ensure that topics such as the social determinants of oral health, the impact of environmental factors and the role of mental health in oral hygiene are brought to light for researchers and policymakers. It is hoped that these insights will contribute to the development of future Health Research Priorities documents for Malaysia and ultimately enhance the uptake of oral health research.
To the best of our knowledge, although individual studies have been conducted, no comprehensive synthesis currently exists that provides a national overview of oral health research output, particularly following the COVID-19 pandemic. Mapping this body of evidence will be critical for identifying research strengths, highlighting methodological gaps and setting future research and policy priorities. The need for this review is further supported by the Ministry of Health Malaysia’s emphasis on evidence-based strategies in the National Oral Health Plan. By collating and analysing available studies, this review will support researchers, clinicians and policymakers in aligning oral health research efforts with national health goals. Ultimately, the findings of this review aim to contribute to the advancement of oral health research and improve the delivery of oral healthcare in Malaysia.
Materials and methods
We will conduct a scoping review based on Arksey and O’Malley’s framework to map the landscape of oral health research in Malaysia and identify gaps in the current literature. Arksey and O'Malley’s framework is designed to efficiently map the key concepts, primary sources and types of evidence within a specific research area.12 It includes six stages: (1) identifying the research question; (2) identifying relevant studies; (3) selecting eligible studies; (4) charting the data; (5) collating, summarising and reporting the results; and (6) conducting a consultation exercise, an additional, parallel step involving key stakeholders to inform and validate the study findings. However, due to resource and time constraints, we will exclude stage VI from the current review. The reporting of this scoping review will follow the guidelines and checklist outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR),13 to ensure a comprehensive and standardised presentation of the review process and findings. The study activities are scheduled to commence with data extraction in the fourth quarter of 2025 and are expected to be completed by the second quarter of 2026. Patient and/or the public are not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Identifying the research questions
The research question for this scoping review will be designed to ensure a thorough and comprehensive examination of the evidence through broad and clearly defined inquiries. The primary research question that will guide the findings of this scoping review is as follows:
What research areas within the field of oral health in Malaysia have been published?
This research question will aim to identify and evaluate the various types of research that have been published on oral health within the Malaysian context. It will also provide a detailed overview of the scope, variety and nature of oral health research that has been conducted in the country over the past decade. This, in turn, will support the broader and specific objectives of the scoping review: to gather all existing literature on oral health research relevant to Malaysia and to highlight areas that will require further investigation.
Identifying relevant studies
The initial search for published articles will be conducted across five electronic databases: PubMed, Scopus, Web of Science (WOS), ProQuest and Cochrane. These databases will be selected for their extensive and diverse coverage of peer-reviewed literature and grey literature, ensuring a comprehensive capture of relevant studies.14 PubMed, managed by the National Centre for Biotechnology Information, is a premier biomedical database that offers access to a vast repository of articles in life sciences and medical disciplines, making it crucial for identifying research on oral health, clinical trials and public health interventions. Conversely, Scopus has interdisciplinary reach of articles across health sciences, social sciences and other fields, making it valuable for mapping the broader research landscape of oral health within both medical and dental contexts. On a separate note, WOS is known for indexing high-impact journals. Therefore, it is also an important resource for tracking citation trends and academic influence. It is particularly beneficial for accessing conference proceedings, allowing the review to include emerging research that has not yet been published in journals.15 ProQuest, on the other hand, is a key database for accessing grey literature, including theses and dissertations, ensuring the inclusion of research that may not appear in traditional journal publications but is nonetheless critical for understanding the full scope of oral health research in Malaysia. Finally, the Cochrane database, which specialises in systematic reviews and evidence-based healthcare research, will be instrumental in identifying high-quality studies that inform best practices in oral health.
By leveraging these databases, the scoping review will aim to cover a wide spectrum of oral health research, ranging from clinical studies to policy and public health research, as well as grey literature such as theses, dissertations and conference proceedings. This comprehensive approach will ensure a thorough synthesis of the evidence, enabling the identification of research trends and gaps within the Malaysian context, particularly in the post-COVID-19 period, which we define the post-COVID-19 pandemic period as beginning on 5 May 2023 in alignment with the WHO’s declaration that COVID-19 no longer constituted a Public Health Emergency of International Concern.16
The search terms or specific keywords that will be used in this scoping review are as follows: ((‘mouth’ OR ‘oro’ OR ‘dental health services’ OR ‘dental’ OR ‘tooth’ OR ‘oral’ OR ‘teeth’ OR ‘decay’ OR ‘caries’ OR ‘periodont*’ OR ‘gingivitis’ OR ‘pocket*’ OR ‘gingival’ OR ‘dental cavity’ OR ‘xerostomia’ OR ‘edentulism’ OR ‘noma’ OR ‘oro-dental trauma’ OR ‘cleft lip’ OR ‘cleft palate’) AND ‘Malaysia’)17,21 (see online supplemental table). This scoping review will exclusively include studies pertinent to Malaysia and will cover literature published between 2014 and 2024. The rationale for selecting the past 10 years is to gain a better overview of research progress and publication trends within this timeframe. Additionally, the COVID-19 pandemic has accelerated the development and implementation of digital health in oral healthcare. For example, various teleconsultation platforms, including MySejahtera, Bookdoc, mOralHealth programmes and MeMoSA 2.0, have been introduced.22 23 For documentation purposes, all search results will be recorded in Microsoft Excel and tabulated, as shown in table 1. The table was developed by adapting the thematic framework from Rafie et al,24 which will serve as a guiding structure for data organisation. To minimise potential bias, the framework will be applied flexibly, allowing for the inclusion of additional themes that may emerge during data extraction. Any duplicate studies identified will be removed using the same software.
Table 1. Framework for categorising oral health research into themes and sub-themes.
| Theme | Sub-theme | |
|---|---|---|
| 1 | Dental clinical care and treatment | Reviewing the status of evidence-based dentistry |
| Study of common dental clinical errors and their causes at the studied dental hospital | ||
| Development of diagnostic and therapeutic procedure for the emergency dentistry | ||
| Identifying the prevalence of common oral and dental infections in patients referred to the studied dental hospital | ||
| 2 | Health and prevention | Development of the protocols for the oral health and prevention of dental diseases in specific patients such as the diabetics, etc |
| Reviewing the effectiveness and efficiency of disinfectants in the environmental, equipment and supplies health at the studied dental hospital | ||
| Evaluation of the infection control standards at the health-oriented dental hospital | ||
| Development of preventive and oral health interventions for childhood | ||
| 3 | Education and health promotion | Study of the dentists’ training and education effects on the oral health of patients referred to the studied dental hospital |
| Vocational needs assessment of staff and dentists at the health-oriented dental hospital | ||
| The pattern of dentist–patient relationship at the health-oriented dental hospital | ||
| Development of lifestyle indices related to the oral and dental health | ||
| Educational materials | ||
| 4 | Management of dental care delivery | Designing a comprehensive pattern for evaluating the satisfaction of dental care recipients |
| Assessment of the patient’s safety status at the studied dental hospital | ||
| Study of the prime cost of health-oriented dental services | ||
| Study of the dentists’ practical experiences in meeting the needs of patients referred to the studied dental hospital | ||
| 5 | Policy and its requirement | Development of standards for evaluating and assessing the health-oriented dental hospital |
| Assessment of the health-oriented dental services in terms of equity in health | ||
| Development of the cost-sharing policies for oral and dental health services | ||
| Development of a comprehensive primary care system for oral and dental health | ||
| 6 | Dentistry materials, equipment and technologies | The Health Technology Assessment (HTA) study of using laser technology in dental treatment |
| Evaluation of the effectiveness and efficiency of dental materials and equipment used in the studied dental hospital | ||
| Feasibility study on preparing electronic oral and dental health records at the studied dental hospital | ||
| Stem cells in root canal treatment therapies | ||
| Genetics | ||
| 7 | Social and culture | Knowledge, attitude and practices |
| Behaviour | ||
| Ageing population | ||
| DHP welfare/stress | ||
| Perception | ||
DHP, Discretionary Housing Payments.
This search strategy will aim to find both black and grey literature, ensuring that the findings of this scoping review will be as comprehensive as possible.25 In all settings, every type of original research study design will be considered for inclusion.
Selecting eligible studies and charting the data
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) flow diagram will be employed in this scoping review to detail the flow of information through various phases, starting with the identification of records from databases, screening for duplicates, assessing eligibility and finally including relevant articles, as shown in figure 1.26 It is critical in any scoping review to establish clear eligibility criteria from the outset, particularly to define the inclusion and exclusion criteria, which are essential for ensuring the quality of the studies selected.27
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews flow diagram outlining the study selection process for the scoping review. The diagram shows the number of records identified through database searching and other sources, screened, assessed for eligibility and ultimately included. Adapted from Tricco et al.13.
For this scoping review, the inclusion criteria will be as follows: (1) all publications related to oral health, (2) publications published from 2014 to 2024, (3) studies related to Malaysia and (4) articles written or translated into English language, whereas the exclusion criteria will be (1) studies not related to Malaysia and (2) research unrelated to oral health.
In the first level of screening, after removing duplicate articles, only titles and abstracts of articles will be reviewed to efficiently filter out any irrelevant studies. This process will also prevent unnecessary use of time and resources.28 Articles’ titles and abstracts that fulfil the inclusion criteria will be recorded in a screening form developed by the authors. These articles will then be reviewed by the research team. This process will be conducted independently by two researchers. In cases where discrepancies arise, a third researcher will be consulted to make the final decision. A double-blinded review will be conducted to determine the eligibility of each publication. For articles deemed relevant but not accessible through the databases, the corresponding authors will be contacted via email to obtain full-text copies.29
To organise the results of the studies that will be included in this scoping review, a Microsoft Excel table will be used to systematically record key information from each study, such as publication type, authors, title, aim, subjects or populations, study design, themes and outcomes. This table will serve as a centralised tool for electronically collecting and analysing data from all included studies.
Collating, summarising and reporting the results
This scoping review will aim to offer a broad overview of the current research pertaining to the topic of interest, rather than undertaking a comprehensive analysis of the quality of each individual study. Scoping reviews involve synthesising and analysing a variety of research and non-research sources to obtain a comprehensive understanding of a particular topic or area of evidence. Thus, to draw conclusions from all data collated within each category, it will be necessary to identify multiple articles stemming from a single topic, which will then be grouped and treated as a single unit of analysis (table 1). Table 1 outlined the adapted research themes and sub-themes, which were derived from the framework developed by Rafie et al.24 In alignment with this framework, the included studies will be systematically organised by their main themes and associated sub-themes. This categorisation will enhance clarity and support a more in-depth comparison of findings across studies. The results derived from this synthesis will be reported to describe the findings related to oral health in Malaysia. These findings will offer valuable insights into the current status of oral health research in the country and will provide guidance on future research directions.
Ethics and dissemination
The study has been registered with the National Medical Research Register (NMRR) Malaysia; NMRR ID-25–00125-GVB and Open Science Framework, available at osf.io/hjq6m. This review does not require ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia as it synthesises existing published and publicly available data. The findings will be disseminated through publication in a peer-reviewed journal and presentations at international conferences, following the practices outlined by Karassa et al.30
Supplementary material
Acknowledgements
We would like to thank the Director General of Health Malaysia for his permission to publish this article.
Footnotes
Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Pre-publication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online (https://doi.org/10.1136/bmjopen-2025-101339).
Provenance and peer review: Not commissioned; externally peer reviewed.
Patient consent for publication: Not applicable.
Data availability statement
Data are available upon reasonable request.
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