Southwest Inclusion Oral Health Research Group
Aiming to implement evidence-based practice and rigorously evaluate strategies to improve the oral health of marginalised populations.
The research group is formed of a multidisciplinary team of academics, dental public health practitioners, dental clinicians, other healthcare professionals, and community research partners.
PhD Studentships
The Impact of Inter Professional Education in the Dental Curriculum on Student’s Views towards Social Accountability.
This work will look to evaluate the current Inter Professional Engagement (IPE) module undertaken by students, and the impact of this on their views and attitudes towards disadvantaged groups and social accountability as a dental professional.
This will help to optimise the impact of IPE to Peninsula and act as a framework to foster positive attitudes.
Oral infection and neurological sequala: Cell mechanisms and potential interviews
Oral infections release inflammatory mediations into circulation. It is known that these can pass the blood brain barrier. Research will be done into the mechanism by which this occurs, resulting in elevated risk of ischemic brain injury. This work will help to inform how this can be addressed through anti-bacterial or anti-inflammatory interventions.
Blood Pressure Screening at the Dentist
- Separate to dental treatment, this student and nurse-led research project set up case finding of high blood pressure patients at the dentist within Peninsula Dental Social Enterprise.
- 5% of patients were confirmed as hypertensive and were referred onto their GP or Livewell for further management.
- Since this project, aligned with prevention strategies with the NHS, blood pressure screening at the dentists is becoming more widely available, but this project was one of the early pioneers in primary care
- PDSE is continuing to deliver general health screening via a number of ongoing research projects.
- Work will be published soon on how the oral microbiome changed in these patients, to help explain why people poor oral health have an increased risk of cardiovascular disease.
Find out more by visiting the links below:
For further information, please contact: zoe.brookes@plymouth.ac.uk or amazon.doble@plymouth.ac.uk
Post Doctoral Training Fellowships
Identifying Factors Influencing Oral Health Habits and Dental care Access among Children and Young people with Autism: Evidence synthesis and qualitative stakeholder research
This research is focused on how dental access can be improved for children and your people with ASD (autistic spectrum disorder) by investigating the barriers and enablers to adopting good oral health, and the factors influencing access. This can help to influence pathways and recommendations to healthcare providers, resulting in reduction in disease.
Diagnosis and Prevention of related Odontogenic Tumours and association with Gene Mutations
Aerosol control and mitigation for dental clinical aerosol generating procedures (AGPs)
COVID-19 related research, furthering understanding of the implications of aerosol generating procedures and use on open plan clinics and how this can be controlled.
Impact of the Peninsula Dental Social Enterprise-Model on the dental workforce and local community
This is a vast and comprehensive project that delves into the care PDSE has provided over the past 10 years. Overall, we aim to explore and demonstrate the social, economic, and dental impact of PDSE on the local community over time. Historical reporting reveals not just the types of care PDSE has provided, but who our services have reached, and how these services have changed over time in accordance with population dental-health needs.
We are talking to current students, patients, clinical supervisors, and external dental and political stakeholders to understand their views on PDSE’s current training, services and initiatives. Together, we will use this information to identify areas for future growth through an oral health inequalities lens and share areas of success that may inform the setup of similar programmes wider-afield.
For further information, please contact: samantha.gould@plymouth.ac.uk or pdse.impact@plymouth.ac.uk
Clinical Projects
Toothpaste and Gum Disease
This research is delivering gold standard gum treatment to patients enrolled in the trial, and providing increased access to this treatment for local communities.
It is integrating dental teams (scientists-dentists-hygienists-nurses) to deliver both patient treatment and research outcomes. The project aims to discover how different toothpastes can increase the effectiveness and maintenance of clinical gum treatment and at home oral hygiene over a longer time. The research will also measure the oral microbiome and find out what role specific bacteria play in this recovery.
For further information, please contact: zoe.brookes@plymouth.ac.uk
Culturally Competent Healthcare of Patients
This portfolio of work is being undertaken inside and outside of PDSE.
Research of the menopause has suggested as women age they are more likely to experience dry mouth, gum disease and dental decay.
Our laboratory research is determining whether hormonal changes linked to the oral microbiome explain why some menopausal women have worse oral health.
Our educational research is determining how we then teach students to be more aware of social and cultural difference when treating patients.
Find out more by visiting the link below:
Teaching dental public health using a socially accountable approach.
For further information, please contact: zoe.brookes@plymouth.ac.uk
INDICATE-2
The INDICATE-2 research study, led by the University of Birmingham, aims to identify how many patients visiting high street dental practices may be at risk of, or unknowingly living with, type 2 diabetes or non-diabetic hyperglycaemia (NDH).
This research supports the NHS England Commissioning Standard on Dental Care for People with Diabetes, which encourages dental teams to engage in risk assessment/early case detection of undiagnosed NDH/diabetes and to refer onwards for formal diagnosis and management.
This study is led by the University of Birmingham and is funded by Haleon and the National Institute for Health and Care Research (NIHR).
This project is led by Dr Zehra Yonel and Professor Iain Chapple. For further information, please contact the Project co-ordinator e.c.chapple@bham.ac.uk or refer to the project website here.
Interprofessional collaboration: Integrating the dietitian into the dental practice
Childhood dental caries is associated with underweight, overweight, and obesity, yet these conditions are often addressed in isolation despite diet being a shared modifiable risk factor.
Dietitians could support families requiring additional behavioural, motivational, or social support with dental dietary advice, as well as identify and manage growth concerns through tailored follow-up. Where relevant, dietary guidance could be directly linked to oral health outcomes. Dedicated consultation time with a dietitian may therefore support both preventive oral and wider health practices. However, collaboration between dental professionals and dietitians remains uncommon, and dietary advice may be inconsistent or conflicting when services operate separately, particularly when medical conditions are present.
This project proposes a collaborative model to strengthen dietary assessment and advice within paediatric dental care. It explored barriers and facilitators to dietary care in dentistry (not limited to oral health) to identify where dietitians could add value. Perspectives from dental professionals, dietitians, and caregivers were gathered to assess acceptability of dietitian integration. These findings informed behavioural analysis and a consensus process to determine requirements for dietitian integration within the Peninsula Dental Social Enterprise (PDSE). Final stakeholder workshops will translate these requirements into a care pathway for future piloting.
Find out more by visiting the links below:
Interprofessional collaboration: Integrating the dietitian into the dental practice
Summary of project – 3-minute thesis (University winner)
European Association Dental Public Health Congress Abstract 2025
Book chapter on oral health for the manual of dietetic practice
Best oral presentation 2025 at PGR showcase and best poster prize school of health professions 2024
Elevator pitch award- Preventing Tooth Decay with a Fork, Not just a Filling: A dietitian’s role in paediatric oral and systemic health – NIHR INSIGHT Conference Plymouth
This project is led by Dr Patricia Casas-Agustench (Director of Studies), Dr Raul Bescos, Dr Zoe Brookes, and Professor Robert Witton. For further information, please contact pdse-research@plymouth.ac.uk
Community Projects
Oral healthcare for care experienced children (funded by The Borrow Foundation)
This research aims to provide insights into, and evidence of, the oral health behaviours, dental experience and access to dental services of care experience children and young people (including care leavers).
Working with children and young people in care and care leavers and other stakeholders in a co-design approach, the research team have conducted:
- a rapid review of the co-design approaches used with vulnerable children and young people in health-related research (completed)
- scoping reviews of the existing evidence relating to the dental health of children and adolescents in care (completed)
- interviews with oral health providers, children/adolescents in care, young care leavers, foster carers and support staff to explore experiences of adopting good oral health behaviours and accessing and providing dental care, and to identify recommendations on optimising dental care for care experienced children and young people.
Following analysis of findings, two workshops with stakeholders and external experts was held to reach consensus on recommendations for improving dental care and experiences of children and adolescents in care.
The findings of this research will be used to improve the oral health care for care experienced children and add to national and international knowledge about improving oral health behaviours and dental care access for this group.
Find out more by visiting the links below:
Research summary: What dental needs do care experienced children have and how do they access dental care?
For further information, please contact: martha.paisi@plymouth.ac.uk
Oral health care for autistic children and young people
This project aims to gather insights into oral health, the experience of dental care and access to mainstream dental services for autistic children and young people (CYP). We are exploring what factors influence the oral health of autistic children and young people from the perspective of autistic children/young people, their parents/carers and dental health professionals.
This project is working closely with our research advisory group which includes autistic CYP and their parents. It has also been informed by a series of collaborative workshops with members of a young club for autistic CYP. The research team have conducted/are conducting:
- a systematic review of the literature on the factors influencing oral health behaviours, access to dental care for autistic CYP and the delivery of this care (completed)
- fifty-five interviews with autistic CYP, parents/carers and oral health providers to explore experiences of caring for their oral health and accessing and providing dental care. They also explored participants’ views on how autistic CYP and their families could be better supported to care for their oral health and to access dental care (completed)
- co-produced video exploring autistic CYP views and experiences of caring for their oral health and visiting the dentist (completed)
- a national online survey of parents/carers of autistic CYP and oral health providers to explore those issues and recommendations identified in the qualitative interviews.
Following analysis of findings, a workshop with stakeholders and external experts will be held to reach consensus on recommendations for improving support for positive oral health behaviour and access to dental care for autistic CYP.
The vision is for the research findings to inform the development of dental care services for autistic CYP in Plymouth through the Peninsula Dental Social Enterprise (PDSE). We will also share the findings with the NHS England Southwest Managed Clinical Network for Special Care and Paediatric Dentistry to further improve oral health support and dental care provision for autistic CYP and associated conditions in the southwest and beyond.
Find out more by visiting the links below:
Plymouth youth autism dental project
What affects how autistic children and young people access dental care?
What affects how autistic children and young people care for their dental health?
Oral Health and Autism Workshop
For further information, please contact: martha.paisi@plymouth.ac.uk
EXperIences of oral health STigma study (EXIST study)
The overarching aim of the project is to understand how adults in England experience oral health stigma and to begin to understand how we might tackle it. This is a mixed methods study that aims to investigate public and professional experiences of oral health stigma and to explore ways to destigmatise differences in oral health status.
The first part of the study (quantitative) utilises a questionnaire which will ask a series of questions of patient participants including: participant characteristics, a stigma index used to quantify experiences of oral health stigma and free-text experiences of oral health stigma. The responses to the questionnaire will also help to identify participants for the second part of the study.
The second part of the study (qualitative) will involve one-to-one interviews with people who have lived experience of oral health stigma. The interviews will use a semi-structured approach facilitated by open ended questions.
The Chief Investigator of this study is Dr Janine Yazdi-Doughty, University of Liverpool, and PDSE’s site lead is Dr Martha Paisi. This project is funded by Academy Medical Sciences.
For further information, please contact: martha.paisi@plymouth.ac.uk
Oral Health Improvement and Access in Gypsy, Roma and Traveller Communities
This project aims to map the current evidence on oral health improvement initiatives and access to dental care among Gypsy, Roma, and Traveller (GRT) populations across Europe. It seeks to identify the key barriers and facilitators that influence GRT communities’ ability to engage with oral health promotion initiatives and access oral healthcare services.
In addition, the project aims to identify gaps in knowledge relating to oral health promotion and dental care access within GRT communities, thereby highlighting priority areas for future research and intervention development.
To achieve this, we have conducted a scoping review of the literature. This approach systematically brings together diverse sources of evidence and synthesises their findings to generate practical, evidence-informed recommendations. The review distils lessons from existing research into workable strategies that can improve access to dental services and enhance the effectiveness of oral health promotion initiatives for GRT populations.
The findings will directly inform PDSE’s approach to improving dental health promotion and access for Gypsy, Roma, and Traveller communities, supporting the development of targeted, culturally responsive, and evidence-based interventions.
For further information, please contact: martha.paisi@plymouth.ac.uk
Integration of dental services into health and social care for people with complex needs
Impact of community engaged dental education
As part of its spiral curriculum, Peninsula Dental School has developed an innovative community engagement module; ‘‘Inter-Professional Engagement (IPE)’’, which runs during the first two years of the undergraduate dental (BDS) and dental hygiene and therapy (DTH) programmes, and it is centred on social accountability. The IPE module introduces students to the concepts of community engagement and social accountability, through experiential learning, in an attempt to develop students’ societal and community awareness so they recognise their future role in the healthcare system and wider society. The module seeks to improve students understanding of public health issues, oral health inequity, and the social determinants of health and how they affect particular population groups.
This research aims to explore the impact of community engaged dental education on undergraduate student’s views towards social accountability, empathy and attitudes towards interprofessional learning.
The findings of this research will be used to inform educational practice and to help us identify elements of IPE with the most influence on student’s views and attitudes towards social accountability. By producing a socially accountable workforce, it is anticipated that the needs of the most vulnerable populations in the society can be appropriately met and that way narrow oral health inequity.
Find out more by visiting the links below:
Teaching dental public health using a socially accountable approach
For further information, please contact: anastasios.plessas@plymouth.ac.uk
Impact of the urgent and stabilisation care provided at the new Dental Education Practice on oral health inequalities and oral-health related quality of life measures
Staff and student experiences of digital dentistry at PDSE
PDSE is currently phasing in an increased use of digital assets within its teaching provision. This transition forms part of a broader cultural shift within dentistry, moving away from traditional analogue techniques toward digital workflows.
This project aims to evaluate students’ and staff members’ perceptions and experiences of implementing digital workflows in dental education. Specifically, it seeks to identify perceived barriers and enablers, explore the practical implications for clinical training and patient care, and generate insights to inform the future delivery and optimisation of digital workflows within the curriculum.
Semi-structured interviews were conducted with 15 Bachelor of Dentistry students and 6 clinical supervisors. Data analysis has been completed, and the findings are currently being written up.
For further information, please contact: martha.paisi@plymouth.ac.uk or robert.witton@plymouth.ac.uk
Factors impacting access to dental care and effective oral health behaviours during pregnancy
Firstly, we reviewed existing qualitative literature to understand factors (identified by pregnant people and healthcare professionals) that impact whether people can access effective oral healthcare during pregnancy. We thematically-analysed these factors and identified that oral health awareness is crucial to promote access to dental services and the adoption of effective oral health behaviours during pregnancy. Awareness alone, however, only goes so far.
With integrated-training on safe pregnancy-specific oral health / dental-practices for dentists, midwives, and wider-health practitioners it could also be possible to deliver oral-health signposting, screening, and even triage at during wider pregnancy-related appointments, providing further-opportunities to promote awareness and breaking down existing barriers to care. Other personal, social, and systems-barriers to good oral health in pregnancy, along with opportunities to address these were also identified.
We are now working to secure funding to develop initiatives to improve oral health awareness and address some of the systems barriers identified through this work. If successful, these pilot initiatives may improve dental access and increase the uptake of effective oral health behaviours during pregnancy.
For further information, please contact: samantha.gould@plymouth.ac.uk
Improving the oral health of people in prison and on release
Working with individuals with lived experience of the criminal justice system and a range of community partners in a co-produced and participatory approach, the research team have conducted:
- a global scoping review of oral health improvement initiatives implemented within prison settings, identifying gaps in provision and areas for future development
- co-production of a short film to raise awareness of the oral health experiences of people returning to the community after being in prison, with a particular focus on barriers to accessing dental care on release
- a participatory research study to co-develop questionnaires to assess the oral health needs of people in prison and on release
This portfolio of research addresses the growing evidence that people in prison and on release experience significantly poorer oral health than the general population.
The findings from this research will be used to shape future research with the aim of designing dental and oral health improvement services that best meet the needs of these groups.
Find out more by watching the video below and visiting these links:
A scoping review of interventions to improve oral health in prison settings
Co-designing a film showcasing the dental experiences of community returners (ex-offenders)
For further information, please contact: joelle.booth@plymouth.ac.uk
Watch the film below on showcasing the dental experiences of community returners (ex-offenders) in relation to the research on improving the oral health of people in prison and on release.
Meet The Team
Dr Martha Paisi
Research Lead
Professor Robert Witton
Chief Executive, Director
Anastasios Plessas
University of Plymouth
Afsha Musa
University of Plymouth
Samantha Gould
Research Fellow
Joelle Booth
University of Plymouth
