The systematic exclusion of dentistry from pandemic response infrastructure represents a blind spot with measurable consequences — one that a new scoping review quantifies for the first time across national taskforces, funding streams, and surveillance systems. As health systems worldwide reassess their pandemic architecture, understanding which professional domains were structurally sidelined matters for building more resilient responses to future infectious disease threats.
A scoping review following PRISMA-ScR methodology analyzed 26 eligible studies drawn from an initial screening of 2,569–3,860 records in PubMed/MEDLINE and Scopus, covering publications from 2000 to 2025. The evidence was organized using the WHO Health System Building Blocks framework and addressed four targeted questions about oral health's role during COVID-19. The central finding is stark: oral health professionals were near-universally absent from national COVID-19 taskforces, and dedicated funding was entirely nonexistent. This occurred despite accumulating evidence linking poor oral health — particularly periodontal disease — to more severe COVID-19 outcomes, plausibly through systemic inflammatory pathways and aspiration of oral bacteria into already-compromised respiratory tracts. Oral health's omission from global health security architecture further compounded the exclusion at the policy level.
The gap identified here is not merely administrative. Research published across the pandemic period has connected saliva-based diagnostics to early COVID-19 detection, and dental professionals possess both aerosol management expertise and population-level point-of-contact access that proved underutilized. This review joins a small but growing body of literature arguing for oral health's integration into broader public health frameworks — a position long advocated by periodontists and oral medicine specialists but rarely translated into emergency planning. The critical limitation is the modest evidence base: 5–8 eligible studies per research question, which constrains causal claims. Still, the convergent narrative across distinct health systems and methodological approaches lends the finding credibility. This work is best characterized as confirmatory and consolidating rather than paradigm-shifting — but in pandemic planning, confirmation of a structural gap is itself a policy-relevant signal.