Oral Health Status of Sex Workers Across the Globe: A Systematic Review.

INTRODUCTION: Despite the high vulnerabilities of sex workers to poor oral health, there is a substantial global gap in comprehensive evidence regarding their oral health status, reflecting a broader neglect of their oral healthcare needs in public health discourse. In light of this, our systematic review seeks to synthesize and consolidate current global research on the oral health status of sex workers, highlighting the prevalence of oral disorders among the group. METHODS: A search method was developed to find papers indexed in three electronic databases. Studies addressing the oral health of adult sex workers, whether female, male, or LGBTQ+, were considered. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS). The findings from the included research were synthesized and provided in a narrative format. RESULTS: Out of 4185 studies, 11 were included in the analysis. Four studies found that the prevalence of oral lesions among sex workers ranged between 8.14% and 81.35%. Oral sexually transmitted infections (OSTIs) were identified, including human papillomavirus (HPV), chlamydia trachomatis, and Neisseria gonorrhoeae. Furthermore, half of the sex workers were reported to use substances, including alcohol, cigarettes, and tobacco. A high frequency of dental cavities and poor periodontal health was also reported. CONCLUSION: The most prevalent oral health conditions among sex workers include oral lesions, dental caries, periodontitis, and oral STIs. Substance abuse, notably smoking in various forms, is also extremely widespread. Designing and implementing tailored health interventions addressing substance abuse, stress management, good oral health, and hygiene practices, as well as training dental professionals on the use of inclusive language in clinical settings, are critical to encouraging sex workers to seek help for oral health issues, thereby improving their oral health outcomes.