Homeless in North and West Belfast: Oral Health Needs Assessment

This work was prompted by the 2004 BDA ‘Dental Care for Homeless People' report which called for local needs assessment to be conducted, in order to target the delivery of dental care for this socially excluded group . Objective: To assess the oral health needs of a homeless population in North and West Belfast. Method: Cross-sectional survey. A convenience sample of 317 single homeless people was examined across 14 hostels located in North and West Belfast. All participants who consented received an oral health examination and completed a medical and social history questionnaire including the Oral Health Impact Profile (OHIP-14). Results: Two hundred and sixty seven (84%) were male and fifty (16%) were female. The results showed that this homeless population had greater mean numbers of missing (7.65) and decayed (3.54) teeth than the settled, general population in Northern Ireland. 22 percent of the sample population were found to have a loss of attachment of 4mm or more. 1% was diagnosed with oral carcinoma. The medical and social history data gathered illustrates the special requirements of this group, with a significant percentage (33%) suffering from psychiatric illness, addictions or complex medical problems. High experience of dental disease was found to impact negatively on quality of life with 31% of participants experiencing 10 or more oral health impacts. Those participants with high oral health impacts had significantly greater mean numbers of decayed teeth (P<0.05) and significantly greater total mean DMFT (P<0.05) compared with those who had low oral health impacts. Furthermore those with a high number of oral health impacts had significantly higher mean scores for CPI compared with those who had low oral health impacts (P<0.01). Conclusions: Oral health, general health and psychosocial factors must be taken into consideration when planning the delivery of context-sensitive dental services for homeless populations.