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Learn more: PMC Disclaimer | PMC Copyright Notice Int Dent J . 2026 Mar 31;76(3):109334. doi: 10.1016/j.identj.2025.109334 Search in PMC Search in PubMed View in NLM Catalog Add to search Mapping the Intersection of One Health and Oral Health: A Citation Analysis of Human, Animal, and Environmental Interconnections Colman McGrath Colman McGrath a Faculty of Dentistry, The University of Hong Kong, Hong Kong, PR China Find articles by Colman McGrath a , Raman Bedi Raman Bedi b World Federation of Public Health Associations, Institute of Global Health, University of Geneva, Geneva, Switzerland Find articles by Raman Bedi b , Sam WS Li Sam WS Li c Department of Health, Centre for Health Protection, Hong Kong, PR China Find articles by Sam WS Li c , Jingwen Li Jingwen Li a Faculty of Dentistry, The University of Hong Kong, Hong Kong, PR China Find articles by Jingwen Li a , Liwu Zheng Liwu Zheng a Faculty of Dentistry, The University of Hong Kong, Hong Kong, PR China Find articles by Liwu Zheng a , Shan Huang Shan Huang a Faculty of Dentistry, The University of Hong Kong, Hong Kong, PR China Find articles by Shan Huang a, ⁎ Author information Article notes Copyright and License information a Faculty of Dentistry, The University of Hong Kong, Hong Kong, PR China b World Federation of Public Health Associations, Institute of Global Health, University of Geneva, Geneva, Switzerland c Department of Health, Centre for Health Protection, Hong Kong, PR China ⁎ Corresponding author. Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, the University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, 999077, PR China. [email protected] Collection date 2026 Jun. © 2026 The Authors This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). PMC Copyright notice PMCID: PMC13066958 PMID: 41921446 Abstract Objectives The concept of ‘One Health’ emphasizes the intrinsic connection of ‘Human Health’ with ‘Animal Health’ and ‘Environmental Health’. The research landscape of the intersection of one health in the oral health context is largely unknown, and so a citation analysis was conducted. Material and Methods A citation analysis was performed following a scoping review within the context of one health and oral health to determine the interaction between oral health with animal health and environment health. The impact and scholarly interconnectedness of research articles within the field, the development of the concept of one health, citations by country, journal type and authors were mapped to provide insights into the scholarly impact of individual works, collaboration patterns among researchers, and the evolution of one health topics over time. Results The analysis identified 114 publications covering three main aspects of the one health concept – human health, animal health & environment health from the Scopus database. There is a growing interest in the intersection of oral health and its mutual effect on animal and environment health with most publications occurring after 2011 (95 out of 114), especially concerning zoonotic infections. Country-level variations were analysed, and a strong citation interconnectedness was observed. Three dimensions, including oral health, animal health and environmental health, were presented using total-link-strength. Publications per author were not high but there was still evidence of interconnectedness in the field. Conclusions Findings from a citation analysis highlight the emergence of one health in the oral health context globally. Clinical Relevance The findings underscore the importance of interdisciplinary and international cooperation in advancing research on one health in the context of oral health with potential opportunities for future research, policy and practice. Key words: One health approach, Dentistry, Environment health, Animal health, Human health Introduction The critical role of ‘ One Health ’ has been increasingly acknowledged as an integrated global approach for addressing shared health threats at the human–animal–environment interface. 1 The concept of One Health traces back to the 1960’s, building on the term One Medicine , which recognized the interconnectedness between animal and human health. 2 As understanding of ecosystem interdependence has deepened, environmental factors – such as food and water security, and climate change – have been identified as key drivers influencing disease transmission and the emergence of drug‐resistant microbes. 3 The concept of One Health has gained significant recognition in recent years, especially following the global pandemic, such that the Quadripartite Organizations (1) the Food and Agriculture Organization of the United Nations (FAO), (2) United Nations Environment Programme (UNEP), (3) World Health Organization (WHO) and (4) World Organisation for Animal Health (WOAH) established the One Health High-Level Expert Panel (OHHLEP) to coordinate and support One Health initiatives. 2 As a leading One Health Initiative (OHI), WHO has empowered different sectors to adopt a stepwise One Health approach to advance the Sustainable Development Goals (SDGs). The current strategic objectives of the OHI are as follows: (1) Enhancing One Health leadership and political advocacy, (2) Building and strengthening partnership within and beyond UN organizations, (3) Strategic planning for One Health implementation at regional and country level. 4 The Quadripartite Organizations (FAO, UNEP, WHO and WOAH), have established several action tracks including (1) Enhancing One Health capacities to strengthen health systems, (2) Reducing the risks from emerging and re-emerging zoonotic epidemics and pandemics, (3) Controlling and eliminating endemic zoonotic, neglected tropical and vector-borne diseases, (4) Strengthening the assessment, management and communication of food safety risks, (5) Curbing the silent pandemic of antimicrobial resistance, (6) Integrating the environment into One Health. 5 FAO, WHO, and WOAH have jointly developed the Tripartite Zoonoses Guide to encourage multisectoral, One Health approach to address zoonotic diseases. 6 The United Nations has also advocated that One Health should be translated into local-level systems due to the rise of zoonoses and given the close interconnection between the health of humans, animals and ecosystems. 7 These actions aim to foster interdisciplinary collaboration and strengthen the collective capacity to mitigate the impact of existing and emerging health threats at the human-animal-environment interface. The integration of One Health principles into oral health remains underdeveloped, despite its demonstrated relevance. Zoonotic diseases like COVID-19 not only exhibit oral manifestations but also directly influence oral health outcomes and pose significant challenges to the safe provision of dental care. 8 , 9 In addition, it is acknowledged that oral health is influenced by humans, animals and their shared environment, and vice-versa. 10 , 11 , 12 , 13 Given the dearth of specific focus on the intersection between One Health and oral health, a scoping review was undertaken. 10 , 14 To this end, a citation analysis was undertaken to trace the scientific development of One Health in the context of oral health. The study aimed to identify influential publications and delineate the evolving research fronts within the field. We mapped the strength of links between different publications, journals, authors, period and origins, fostering a deeper understanding of collaborative networks and dissemination of knowledge in the context of One Health and oral health. Methods Identification of one health and oral health publications The bibliometric data for this study originated from a PRISMA-guided scoping review in this domain 14 ; Figure 1 ). The preliminary analysis revealed a constrained dataset with weak citation linkages. To address this limitation and identify a broader evidence base, a second search was executed in the Scopus database. Scopus was prioritized for this purpose due to its authoritative citation indexing and multidisciplinary scope, justifying its selection for a comprehensive citation network analysis. The search strategy involved the use of keywords related to one health and oral health as follows: 1. INDEXTERMS ("one health"); 2. TITLE-ABS ("one health" OR "OneHealth" OR "one-health" OR "one health approach*" OR "one health concept*" OR "one health perspective*" OR "one health initiative*" OR "one medicine*" OR "one medicine initiative*" OR "conservation medicine*" OR "one science" OR "one world" OR " EcoHealth"); 3. #1 OR #2; 4. INDEXTERMS ("oral health" OR "dental health" OR "mouth disease” OR "tooth disease" OR "oral hygiene" OR "mouth mucosa" OR "Jaw diseases" OR "dentistry"); 5. TITLE-ABS ("oral health" OR "dental health" OR "mouth disease*" OR "tooth disease*" OR "oral hygiene" OR "dental caries" OR "tooth decay" OR "tooth loss" OR "dental plaque" OR "periodont*" OR "gingiv*" OR "orofacial trauma" OR "mouth tumor" OR "mouth neoplasm*" OR "oral cancer" OR "dentistry" OR "oral mucosa*" OR "oral manifestation" OR "Tooth Extraction"); 6. #4 OR #5; 7. #3 AND #6. Fig. 1. Open in a new tab Flow diagram of conducting citation analysis. The study's objective to map the temporal evolution of the One Health concept dictated that no restrictions be placed on publication dates. Publications primarily focusing on the one health framework or its components ( Animal Health, Human Health , and Environmental Health ) were considered. A final dataset consisting of 114 full-length, peer-reviewed original research articles published in English were identified for the citation analysis. Publication-related information included (1) authors, (2) journal, (3) countries, (4) key words, (5) main topics were exported in CSV format and imported in VOSviewer software for further processing. Bibliometric data analyses The bibliometric data were analyzed using VOSviewer (Version 1.6.20) to visualize networks based on the topic of one health and oral health. The number of publications, citations and total link strength (a positive numeric value with a higher value representing a stronger link), of included journals, authors across different countries were analysed and mapped to visualize the emerging trends and potential interdisciplinary connections globally. All included titles and abstracts were analysed to identify the occurrence and co-occurrence of terms over the period of publication to provide insights into the recognition of the concept of One Health. Keywords analysis was conducted to identify prevailing research themes within the one health literature over the study period. Maps of bibliographic citation analysis were produced to determine the following profiles (1) country (from author affiliations), (2) journal of publication (source title), and (3) key authors. Prior to any analysis, consistency of terms for the country, journal, and authors were confirmed. In the analyses, a default setting of 25 as the maximum number of countries per publication was selected. When choosing thresholds, 1 was selected as the minimum number of publications of a country level and 1 was selected as the minimum number of citations of a country level. The relatedness of aspects such as country, journal, and key authors was measured based on the number of times it was cited. Larger circles in the maps denote higher numbers of citations, and circles with the same colour indicate their connectedness. Data analysis applying VOSviewer Collected data in CSV format were analysed using VOSviewer. Descriptive statistics were generated to summarize the number of publications per year, the most prolific authors, and the leading journals in which one health research was published. Co-citation and collaboration networks were constructed using VOSviewer software, which allowed for the visualization of relationships between authors and institutions, and identification of major research clusters. Results Trends in publication of one health and oral health Amongst the 114 included publications, the vast majority were published after 2011 (95 out of 114 publications), and few articles were published in 2011 or before (15 out of 114 publications). Based on the Scopus text data of included titles and abstracts of all publications, 1910 terms were identified. Among them, the term ‘human’ emerged more than 70 times with link strength at 1512. The term ‘one health’ occurred 35 times with 788 link strength, and with an average publication year of 2021.26, possessing a visualized connection with ‘zoonosis’, ‘foot and mouth disease’, ‘animals’, ‘food safety’, ‘COVID-19’, among other terms. In the context of oral health, the term ‘oral health’ occurred 19 times with total link strength of 297, and the average publication year was in 2014.58, mostly concerning dental care and periodontal disease. The key terms by year are mapped in Figure 2 . Fig. 2. Open in a new tab Key words of one health and oral health mapped by year. Source and publication/citation records of one health and oral health Authors from 52 countries were identified from the included publications. The vast majority of publications were from the United States (n = 29), followed by the United Kingdom (n = 13) and India (n = 8). The citation count from United States origins was 461 followed by 353 from the United Kingdom; more than fifty times that of Indian (n = 8). The numbers and publications for the 52 countries are detailed in Table 1 . Publications from United States had the strongest impact, with a total link strength of 20, then the United Kingdom at 18, while the rest had link strength of no more than 10. The bibliocoupling by countries in link strength is presented in Figure 3 . A total of 93 journals were included in the citation analysis, with 16 journals connected in citations. Among the publications, 8 out 37 publications were from dental-specific journals: BMC Oral Health (2 publications, 32 citations), Community Dental Health (2 publications, 3 citations), Community Dentistry and Oral Epidemiology (2 publications, 34 citations), Journal of Oral Education (2 publications, 41 citations). Commonly, included publications (29 out of 37 publications) were published in non-dental specific journals: Antibiotics (3 publications, 10 citations), PloS One (4 publications, 131 citations), Indian Journal of Community Medicine (2 publications, 0 citations), Journal of Veterinary Medical Education (2 publications, 25 citations), Omics a Journal of Integrative Biology (2 publications, 29 citations), One Health (2 publications, 47 citations), PloS Neglected Tropical Diseases (2 publications, 19 citations), Transboundary and Emerging Diseases (4 publications, 87 citations), Veterinary Record (2 publications, 4 citations), Veterinary Technician (2 publications, 0 citations), Viruses (2 publications, 23 citations). Altogether, 554 authors were identified to have publications on the above-mentioned journals. The major bibliographic coupling by authors is mapped in Figure 4 . The overall characteristics of dimensions of the selected studies are profiled in Table 2 . Table 1. Rank of key countries, authors, and journals with the number of publications and citations. Subjects No. of publications/citations Total link strength A. Country United States 29 743 United Kingdom 13 423 India 8 159 Brazil 6 144 France 5 471 Sweden 5 374 Ireland 3 390 Thailand 4 245 Italy 6 130 B. Journal PloS One 4 5 Atibiotics 3 16 BMC Oral Health 2 0 Community Dentistry and Oral Epidemiology 2 0 Community Dental Health 2 0 Indian Journal of Community Medicine 2 0 Journal of Dental Education 2 0 Journal of Veterinary Medical Education 2 0 Omics a Journal of Integrative Biology 2 0 One Health 2 2 Transboundary and Emerging Diseases 4 5 PloS Neglected Tropical Diseases 2 0 Veterinary Technician 2 0 Veterinary Record 2 0 Viruses 2 1 General Dentistry 1 5 Defence Life Science Journal 1 10 Animals 1 2 C. Author Call Doglas R 80 421 Besinis Alexandros 46 512 Hang ombe Bernard 20 687 Fomsgaard Anders 21 118 D. Year 1965-2011 19 17 2012-2024 95 97 Open in a new tab Fig. 3. Open in a new tab The bibliocoupling by countries in link strength. Fig. 4. Open in a new tab Author collaboration network analysis. The network map visualizes collaborative relationships among authors in the research domain. Nodes represent individual authors, with size reflecting the citations. Lines between nodes indicate documented co-authorship, with thicker lines suggesting stronger or more frequent collaboration. Table 2. Details of classification of included publications in the dimension of Oral Health, Environment Health and Animal Health. Article/study type Journal type Number Specific topics Oral /human health and one health Review Dental-specific 1 Aging and Oral Health Non-dental-specific 12 Oral microbial (1), Virus infection (4), environment related (1), other (6) Cross-sectional study Dental-specific 1 Education on Oral Health Non-dental-specific 5 Antimicrobial-resistance (1), Environment to oral health (2, water management and climate change), other (2) Qualitative study Dental-specific 1 Oral health Non-dental-specific 3 Oral health assessment (1), Human health (2) Observational study Dental-specific 2 Oral health assessment (1), Oral health to environment health (1) Non-dental-specific 1 Human health Retrospective study Dental-specific 1 Oral health and environmental health Non-dental-specific 2 Human health (Disease prevalence) Longitudinal study Dental-specific 3 Oral health Non-dental-specific 0 RCT Dental-specific 0 Non-dental-specific 1 Oral health and environmental health Environmental Health Related Review Non-dental-specific 5 Food-safety (2), Environment-related animal diseases (2), Environment-related human health (1) Cross-sectional study Non-dental-specific 3 Occupational exposure (1), Water management (1), Climate change (1) Observational study 1 Oral health and environmental health RCT 1 Oral health and environmental health Animal health related Review Non-dental-specific 22 Animal diseases and zoonotic infection (16), Vaccination (3), Animal law (1), Animal health and environment (2) Cross-sectional study Non-dental-specific 2 Zoonotic infection Qualitative study 4 Zoonotic infection (3), Antibiotic resistance (1) Observational study 1 Zoonotic infection Retrospective study 1 Zoonotic infection and antimicrobial resistance Longitudinal study 1 Animal health RCT 1 Animal health Open in a new tab Discussion This citation analysis investigated research relating to aspects of one health in the oral health context: the publication trends, collaboration networks, thematic evolution, interdisciplinary approaches and global perspective. Co-occurrence, citation, and link strength maps provide insights into how one health is operationalized within the oral health context. A PRISMA-guided systematic scoping review was first conducted, 14 followed by citation analysis using Scopus and VOSviewer. Scopus is one of the largest and most comprehensive database for citation analyses in terms of usefulness in describing bibliometrics; albeit relying on a single database has limitations in terms of coverage, especially with respect to the grey literature. 15 The majority of the studies identified in this citation analysis focused on animal health and zoonotic diseases. It is acknowledged that the results may to some extent be influenced by journal and authors factors for example only English language articles were considered, albeit English is the lingua franca of science. Furthermore, the scholarly impact and interconnectedness through citations presented are not in themselves measures of research quality. A qualitative synthesis of the evidence based on thirteen publications retrieved from five electronic databases has previously been published in the associated scoping review. 14 Of note, the citation analysis provided a broad mapping of collaboration patterns across countries and link between authors but VOSviewer is limited in providing special details of level of collaboration between and within countries. 16 Zoonotic infections like anthrax and tularaemia can have oral manifestations. 17 Besides, a vector-borne virus, Chikungunya can manifest in varied ways in the oral cavity including oral ulcers, erythema, pigmentation et al, reinforcing the One Health principle that the health of humans is inextricably linked to the health of animals and our shared environment. 18 SARS-CoV-2, rabies, and monkeypox (Mpox) can be transmitted via the oral cavity and cause manifestations such as enanthems, ulcerations, and salivary gland involvement. 19 , 20 During the COVID-19 pandemic, oral manifestations of SARS-CoV-2 were widely reported 21 and concerns about infection control in dental settings intensified. 9 Transmission of SARS-CoV-2 occurred via (1) inhalation of respiratory droplets, (2) direct mucosal contact, and (3) contaminated surfaces in oral care environments. 22 WHO advised postponing non-urgent oral care to mitigate risk. 22 Though the One Health concept has existed in medicine for decades, its uptake in oral health literature is more recent. Interest has surged since 2020, prompted by the pandemic, climate change, and antimicrobial resistance. 8 , 3 , 23 Not only does One Health have numerous thematic areas that intersect with oral health, sustainable dentistry is in fact an issue of environmental sustainability. 24 Moreover, dentists contribute to antimicrobial resistance when prescribing practices are inappropriate, and they have a role in global mitigation efforts. 25 Meanwhile, few studies have examined environmental determinants of oral health such as water scarcity and climate change. 13 Most included studies were narrative reviews; randomized trials were rare. However, clinical research has recently expanded in the context of COVID-19. 26 , 27 Geographically, most studies originated from high-income countries. Yet, the burden of zoonotic and environmental risk falls more heavily on low- and middle-income countries in Africa and Asia. 28 , 29 , 30 , 31 The predominance of non-dental journals may increase visibility but reduce accessibility for oral health practitioners. Collaboration between authors was limited, with generally low link strength across networks – indicating an urgent need for cross-border collaboration and interdisciplinary research. Fostering closer collaboration in the academia would be a major step towards interdisciplinary education and collaborative practice. Medical schools and veterinary schools around the world have been rolling out initiatives to enhance One Health education. 32 Universities should also enrich dental education and training that aim to prepare and ensure dental health professionals are included in One Health developments. Meanwhile, high-level One Health multi-agency coordination mechanisms should be in place across international, regional and local levels, and such mechanisms should engage dental health professionals and solicit their continuous participation. Conclusion In summary, this citation analysis highlights the emergence and growing interest in One Health within the oral health context. Most studies relate to animal health and zoonotic infections, particularly COVID-19. Since 2020, there has been rapid expansion in this field, and interest is increasingly extending to the environmental determinants of oral health. However, current studies remain limited in number, quality, and geographical diversity. Interdisciplinary collaboration is still sparse. The findings have clear implications for future research, policy, and clinical practice in oral health and public health, particularly in embedding One Health as a guiding framework in oral healthcare systems and dental health education worldwide. Conflict of interest None disclosed. Acknowledgments Availability of data and materials All supporting data for this review are included within the manuscript. Funding This study was supported by the general research fund from the Research Grants Council of the Hong Kong Special Administrative Region, China (Grant number: 17107621). Author contributions Colman McGrath: Conceptualization, Formal analysis, Funding acquisition, Methodology, Resources, Writing – review & editing & Supervision. Raman Bedi: Writing – review & editing. Sam W. S. Li: Conceptualization, Methodology & Writing – review & editing. Jingwen Li: Writing – review & editing. Liwu Zheng: Methodology, Supervision & Writing – review & editing. Shan Huang: Formal analysis, Investigation, Methodology & Writing – original draft. References 1. Sinclair J.R. Importance of a one health approach in advancing global health security and the sustainable development goals. Rev Sci Tech. 2019;38(1):145–154. doi: 10.20506/rst3812949. 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