07/22/2026
The Oral Cavity as a Window to Systemic Disease: Diagnostic Clues and Pre-treatment Dental Management for Interdisciplinary Trainees
The oral cavity frequently harbors the earliest clinical manifestations of systemic diseases, yet a persistent knowledge gap exists between dental and medical training programs regarding oral-systemic correlations. Simultaneously, pre-treatment dental evaluation before oncologic therapy and cardiac surgery remains an underutilized step that, when omitted, can lead to osteoradionecrosis, infective endocarditis, treatment delays, and increased morbidity. This narrative review aimed to catalog oral diagnostic clues, organized by organ system, and to synthesize current pre-treatment dental protocols for oncologic and cardiac surgical patients, targeting interdisciplinary trainees in dentistry and internal medicine. A literature search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library.
MY NOTE: This manuscript provides a broad narrative overview of oral manifestations associated with systemic disease and outlines pre‑treatment dental management considerations for interdisciplinary trainees. The topic is clinically relevant and aligns with current efforts to strengthen medical–dental integration. The authors present a comprehensive catalog of conditions with oral findings, including hematologic, autoimmune, gastrointestinal, endocrine, dermatologic, and infectious diseases, and they incorporate multiple contemporary guidelines (ADA, MASCC/ISOO/ASCO, ACC/AHA, AAOMS). The educational intent is clear, and the manuscript is well organized for learners.
However, the scholarly rigor is limited by the absence of systematic methodology. Although the authors state that they consulted PubMed, Scopus, Web of Science, and Cochrane, no search strategy, inclusion/exclusion criteria, or study selection process is described. The review relies heavily on secondary sources and narrative summaries without critical appraisal of evidence quality. Several statements overgeneralize findings or present associations without contextualizing strength of evidence, diagnostic performance, or controversies in clinical practice (e.g., MRONJ drug holidays, ORN prophylactic hyperbaric oxygen, variability in cardiac surgery dental clearance protocols). Tables are useful but would benefit from clearer sourcing and differentiation between high‑quality evidence and expert opinion.
Overall, the manuscript has strong educational value but modest scholarly rigor. It is appropriate for interdisciplinary teaching and CE contexts but requires methodological strengthening and deeper critical analysis to meet the standards of higher‑tier peer‑reviewed journals.
The oral cavity frequently harbors the earliest clinical manifestations of systemic diseases, yet a persistent knowledge gap exists between dental and medical training programs regarding oral-systemic correlations. Simultaneously, pre-treatment dental evaluation before oncologic therapy and cardiac....
