<b>Barriers to Oral Health Care Access in TB Patients: A Cross-Sectional Study</b>

Background: Tuberculosis (TB) remains a major public health concern in Pakistan, which ranks among the top five high-burden countries globally. Despite advances in TB management, oral health care for TB patients is often overlooked. Oral manifestations, though infrequent, can serve as early diagnostic indicators and significantly impact patient well-being. However, limited awareness, stigma, and insufficient training among dental professionals may hinder effective care delivery. Objective: To assess the knowledge, awareness, and perceived barriers among dental professionals in Pakistan regarding the provision of oral healthcare to TB patients, and to identify factors influencing clinical decision-making and care accessibility. Methods: A cross-sectional observational study was conducted between May and June 2024 using a self-administered online questionnaire targeting clinical-year undergraduates, house officers, general dentists, and postgraduate trainees across Pakistan. A sample of 203 participants was selected using consecutive non-probability sampling. Descriptive and inferential statistics were analyzed using SPSS v27, with subgroup comparisons and odds ratios calculated to identify predictors of care refusal and knowledge gaps. Results: Only 54.7% of participants were familiar with TB-related dental care guidelines, and 61.1% cited personal infection risk as the primary deterrent to treating TB patients. Stigma (68.5%), lack of awareness (72.9%), and institutional barriers such as inadequate infection control protocols (55.2%) were reported widely. Less experienced professionals had significantly higher odds of refusing or delaying care. Nevertheless, 85.7% supported routine oral evaluations in TB care and 80.3% were willing to participate in integrated TB screening. Conclusion: Significant educational, institutional, and psychosocial barriers impede dental professionals' ability to deliver comprehensive oral healthcare to TB patients in Pakistan. Targeted training, interprofessional integration, and stigma-reduction strategies are essential to bridge these gaps and improve clinical outcomes.