Nurses as oral health champions

Janice E. Hawkins | 12 January 2023

I had the opportunity to attend the oral health Two Risk Factors, Too Many Diseases meeting in Nassau, Bahamas. The meeting was part of the Caribbean Community (CARICOM) Initiative to address oral healthcare challenges and promote universal access. Globally, 3.5 billion people, or almost half of the world’s population, suffer from oral health disease. Oral disease is one of the most common and neglected noncommunicable diseases worldwide. More than 14 million children are affected by untreated dental caries, contributing to missed school days, loss of sleep, pain, and emotional distress. At the meeting in Nassau, I learned that the risk factors associated with poor oral health are the same risk factors connected to over 100 other noncommunicable diseases. Many of these risk factors are modifiable.

The FDI World Dental Federation considers oral health an essential part of overall good health and well-being. Strategies for improvement include increasing oral health literacy, integrating oral healthcare in primary care settings, reducing common risk factors, and advocating for universal insurance coverage. According to the recently published WHO Global Oral Health Status Report, only a small percentage of the world’s population has access to dental services. Even in high income countries, dental services are often not included in insurance plans or government funded programs. Millions of people lack access to dental health providers.

Nurses can play a vital role in improving oral health access by offering promotion and prevention services in the communities we serve. Integrating oral health promotion and prevention in primary care nursing practice is effective. Positive outcomes include reduced numbers of dental caries, better dietary and oral hygiene practices, increased knowledge, and more frequent visits to dental health professionals. As the largest health professional workforce positioned on the frontlines where people live, work, and play, nurses are equipped to address social determinants that are often risk factors for poor oral health outcomes.

I consider myself a champion for better oral health. I am currently on a mission to educate children and parents about the negative health impacts of consuming sugary beverages. I have my calendar marked to celebrate “No Sugar Day,” though the designated day seems to vary by country. Some have recommended expanding this to a full month of “No Sugar November.” I support warning labels and taxation of sugared sweetened beverages to de-incentivize sales. I am a strong advocate for regulating marketing practices that specifically target children and encourage sugary sweets. Following the examples of others, I can lead initiatives to ban sugary drinks in healthcare institutions and schools. Hospitals should serve as role models in discouraging sugary beverage consumption that leads to poor oral and overall health outcomes.

I am also a champion for inclusion of oral health education in nursing programs. Recognizing the connections between oral health and systemic health, we include oral health content in the nursing curriculum where I teach. We use the Smiles for Life online modules and clinical experiences with dental providers to teach oral health knowledge and skills in both our graduate and undergraduate assessment courses. Feedback from students has been very positive.

We also encourage our students to sign up for Sigma’s Oral Health Equity Leader: Pediatric Care course sponsored by Colgate-Palmolive. All nurses can become Bright Smiles, Bright Futures Oral Health Equity Leaders by completing the free online course. Nurses who complete the course receive a free oral health equity leader kit with educational materials and toothbrush and toothpaste samples to share with children in their communities.


Janice E. Hawkins, PhD, RN, is a Clinical Associate Professor at Old Dominion University School of Nursing in Norfolk, Virginia, USA, and is a retired Army nurse. She is a member of Sigma’s Epsilon Chi Chapter at Old Dominion University. 

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