IADR Abstract Archives
Homeless persons’ access to dental services and strategies to improve their oral health: A systematic literature review
Objectives: Homeless people have poor oral health, high treatment needs and tend to make problem based dental visits. To improve oral health, it is essential to provide preventive care rather than simply manage dental problems. This literature review aims to determine how and where homeless people access and receive oral health care and advice, the barriers that prevent homeless adults accessing dental care and the strategies that exist to promote oral health to homeless adults.
Methods: Databases (MEDLINE via OvidSP, PubMed, CINAHL and Scopus) were searched using the key words: homeless, roofless, houseless, rough sleeper, couch surfer, shelter, hostel, dental and oral health. The inclusion criteria were: Papers involved homeless participants over the age of 17, were written in English, based in developed countries and published after 2003. Snowballing techniques were then applied whereby the reference lists of included articles were searched for other relevant papers.
Results: Twenty-one papers met the inclusion criteria and were included in the review.
Homeless people find mainstream dental services difficult to access due to system level barriers, their fear of dental treatment as well as psychosocial and economic factors. Both dedicated outreach services and co-locating dental clinics with other health and social service providers improve oral health access for homeless adults. Dental care is also provided by charities, volunteers and students and emergency care is sought from hospital emergency departments and doctors.
To be successful, oral health messages need to be delivered at an appropriate time when homeless people are ‘reconstructing’ their lives. Support agencies provide oral health products, information about how to access dental services and oral health education.
Conclusions: Homeless people have special dental needs not supported by mainstream dental services. In order to improve their oral health, dental services should be designed in collaboration with other support agencies to address those needs.
Methods: Databases (MEDLINE via OvidSP, PubMed, CINAHL and Scopus) were searched using the key words: homeless, roofless, houseless, rough sleeper, couch surfer, shelter, hostel, dental and oral health. The inclusion criteria were: Papers involved homeless participants over the age of 17, were written in English, based in developed countries and published after 2003. Snowballing techniques were then applied whereby the reference lists of included articles were searched for other relevant papers.
Results: Twenty-one papers met the inclusion criteria and were included in the review.
Homeless people find mainstream dental services difficult to access due to system level barriers, their fear of dental treatment as well as psychosocial and economic factors. Both dedicated outreach services and co-locating dental clinics with other health and social service providers improve oral health access for homeless adults. Dental care is also provided by charities, volunteers and students and emergency care is sought from hospital emergency departments and doctors.
To be successful, oral health messages need to be delivered at an appropriate time when homeless people are ‘reconstructing’ their lives. Support agencies provide oral health products, information about how to access dental services and oral health education.
Conclusions: Homeless people have special dental needs not supported by mainstream dental services. In order to improve their oral health, dental services should be designed in collaboration with other support agencies to address those needs.