## 3 Results
### Attitudes of Nursing Professionals towards Oral Healthcare  
The implementation of oral care programs and interdisciplinary/interprofessional/multi-professional programs was reported to improve the attitudes of nurses towards oral healthcare [14; 16; 18; 21; 23; 24; 46] (Figure 4). A non-randomized intervention trial evaluated the effect of an oral healthcare program in nursing homes on knowledge and attitudes regarding oral health among care staff. The results showed that the oral healthcare program, which included mobile dental care, significantly improved the attitudes of the staff towards oral healthcare [14]. Similarly, the implementation of an oral care program was found to improve the knowledge and attitudes of home care nurses towards oral healthcare and its impact on older people's oral health [16]. In a questionnaire-based study from Japan, the attitudes and confidence levels of nursing students were found to significantly improve after an interprofessional education program. Specifically, the total mean scores on the oral assessment ability tests of the nursing students increased after the interprofessional education program (first test: 6.80 (standard deviation, SD: 1.33); second test: 6.96 (SD: 1.38); third test: 7.88 (SD: 1.01) points). Furthermore, their performance of oral self-assessment increased significantly from 15.8% at baseline to 32.7% after the program [24]. Figure 4: Effects of interventions on the attitudes of nurses towards oral health [14; 21; 23; 24]. Figure 3: Adequate training in oral health [38; 44; 45]. Thirty studies evaluated the attitudes of nursing professionals towards the provision of oral healthcare [4; 16; 18; 21; 22; 23; 24; 25; 27; 33; 39; 40; 43; 44; 45; 46; 47; 48; 49; 50; 51; 52; 53; 54; 55; 56; 57; 58; 59]. Evidence from the included studies showed varying attitudes of nurses towards providing oral healthcare. With few exceptions, nursing practitioners and nursing graduates showed more positive attitudes towards the provision of oral healthcare and the prevention and management of oral health problems vs. trainee/student nurse, midwives, nurses with a diploma, and other professionals [27; 33; 39; 40; 41; 43; 46; 49; 51; 53; 54; 55; 58; 59]. Self-efficacy and attitudes towards providing mouth care were reported to be higher in nurses from public geriatric care facilities than those from private geriatric care facilities, those working in <100 bed vs. >100 bed facilities, and American vs. Chinese nurses [47]. Female nurses reported better attitudes than male nurses (Figure S2 [43]. A Croatian cross-sectional study that assessed the attitudes of 241 ICU nurses showed that they were sufficiently educated about the importance of oral care and the impact of adequate oral care on ICU patients [57]. Similarly, a study by [PERSON] et al. reported that nurses were aware of the relationship between dental and general health, and their role in preventing oral disease [58]. Nurses with a degree and above were more likely to have a positive attitude than diploma holders (AOR = 2.01; 95% CI: 1.012-4.01) [33]. Similarly, trained nurses were 3.54 times more likely to have a positive attitude than untrained nurses about oral care (AOR = 3.54; 95% CI: 1.61-7.79) [33]. The mean score of the nurses' attitude towards oral healthcare ranged from 22.0 (out of a maximum score of 32.0) [58] to 40.32 (out of a maximum score 60.0) [39]. Nurses and pharmacists with fewer years of experience (OR = 1.31, 95% CI: 1.43-3.11) and those with higher degrees (OR = 1.4, 95% CI: 1.47-2.27) reported more positive attitudes toward the prevention and management of dental and oral health problems in post-chemotherapy patients than did those with lower qualifications (\(p\) < 0.05) [49]. In a cross-sectional study that included primary care nurses, higher scores in the pediatric (OR = 1.2) and dental (OR = 1.3) domains and a greater willingness to receive oral healthcare information (OR = 5.3) were associated with a positive attitude toward oral healthcare [58].