Approaches for co-creating oral health programs for adults: A scoping review.

Co-creation is increasingly promoted to develop sustainable oral health programs. Little is known about how co-creation is applied in adult oral health promotion, including learnings from such programs. This review aims to map the characteristics of co-created, preventive, community-based oral health projects targeting adults and to synthesize learnings, including challenges, possibilities, and successes. A scoping review was conducted in accordance with recommended methodological steps. A bibliometric search across major databases and a grey literature search covering all WHO regions identified eligible projects. Inclusion criteria required projects to concern adult oral health, include co-creation elements, be community-based, focus on prevention, include an intervention, and be conducted within the last 10 years. Data extraction and synthesis focused on project characteristics and learnings. Included projects varied in aims, scope, and intervention types. Many sought to improve access to oral health care for vulnerable groups. Stakeholder involvement was generally narrow and dominated by dental professionals, with limited patient participation. Co-creation activities were often sporadic, typically occurring during implementation rather than across all project stages. Reported challenges included resource limitations, recruitment barriers, and difficulties sustaining collaboration. Opportunities arose from adaptive approaches, multi-sectoral collaboration, and the use of existing networks. Successes were mostly process-oriented, with some projects reporting improved oral health literacy, enhanced service access, and strengthened stakeholder relationships. In conclusion, Co-created oral health promotion projects demonstrate potential but are inconsistently implemented and reported. Future initiatives should prioritize early and sustained stakeholder engagement, structured co-creation processes, and systematic evaluation to strengthen impact and sustainability.