Oral Health Care Program For Socially Marginalized And Underserved Citizens

Objectives: To describe oral health and oral health-related quality of life among social marginalized adults in a special oral care program, and to evaluate the effect of oral care on the oral health-related quality of life of these persons.
Methods: Participants of the study were identified by defined criteria, and referred to the program by social workers in social day-centers, where social marginalized persons use to spend time. Dental clinics for the program were arranged to be kind and special responsive to these clients. A well-motivated and positive staff, who would understand the patients’ perceived need and demand for dental care was recruited. In total, 220 participants, (mean 43 years) with drug-abuse, being homeless, permanently unemployed, or with mental problems were offered dental care to restore the dentition to a functional and social acceptable level, by means of low-cost treatment services. Oral status was registered according to WHO recommendations. Oral health behavior was registered by means of a questionnaire; and oral health-related quality of life was measured by means of Oral Health Impact Profile-14-index (OHIP 14). Frequency tables, t-test and non-parametric analyses were applied.
Results: Oral status was poor, 94 % had decayed teeth (mean 9.5 decayed teeth and a mean of 2.7 root remnants). 44% had not visited a dentist within 5 years, and less than one third reported tooth brushing twice a day, 17% brushed their teeth less than once a week. 143 participants completed the dental program within the program period. Among those who fulfilled the program including OHIP14 registration at baseline and after the treatment (n= 99), the OHIP14 score was reduced from 18.1 to 9.9 (p<0.001).
Conclusions: It was concluded that social marginalized people’s oral problems can be solved, and that their oral health-related quality of life can be increased, although it requires special arrangements and special clinical environment.