Homeless adults’ access to dental services and strategies to improve their oral health: a systematic literature review
Jacqueline Goode A B D , Ha Hoang A and Leonard Crocombe C
+ Author Affiliations
- Author Affiliations
A University of Tasmania, Centre for Rural Health, School of Health Sciences, Locked Bag 1322, Launceston, Tas. 7250, Australia.
B La Trobe University, Rural Health School, Department of Dentistry and Oral Health, PO Box 199, Bendigo, Vic. 3552, Australia.
C University of Tasmania, Centre for Rural Health, School of Health Sciences, CML Building, Corner Elizabeth and Macquarie Streets, Hobart, Tas. 7000, Australia.
D Corresponding author. Email: jacqueline.goode@utas.edu.au
Australian Journal of Primary Health 24(4) 287-298 https://doi.org/10.1071/PY17178
Submitted: 7 December 2017 Accepted: 22 March 2018 Published: 9 July 2018
Journal compilation © La Trobe University 2018 Open Access CC BY-NC-ND
Abstract
Homeless people have poor oral health and high treatment needs, yet tend to make problem-based dental visits. This review aimed to determine how and where homeless adults receive oral health care, the barriers that prevent homeless adults accessing dental care and find strategies to promote oral health to homeless adults. The databases MEDLINE via OvidSP, PubMed, CINAHL and Scopus were searched using the keywords: homeless, roofless, houseless, rough sleeper, couch surfer, shelter, hostel, dental and oral health. The inclusion criteria were: participants over the age of 17 years, studies written in English, based in developed countries and published after 2003. Selected articles were assessed using the Mixed Methods Appraisal Tool and data extracted were thematically analysed. Twenty-two studies met the inclusion criteria. Five main themes were found: how homeless people accessed dental care; factors affecting the uptake of care; strategies used to improve access to care; the effect of non-dental staff on dental care; and challenges with providing care to homeless people. Dental care for homeless adults was affected by numerous factors. Improving their access to dental services requires collaboration between support service providers, dental care to be near homeless populations and flexibility by dental services.
References
Abel SN, Kowal H, Brimlow D, Uchin M, Gerbert B (2012) A collaboration to enhance oral health care for survivors of domestic violence: women’s domestic violence shelters and Nova Southeastern University’s College of Dental Medicine. Journal of Dental Education 76, 1334–1341.Abel SN, Bhoopathi V, Herzig K, Godoy M, Kowal HC, Gerbert B (2013) The impact of an oral health program on domestic violence survivors within community shelters. The Journal of the American Dental Association 144, 1372–1378.
| The impact of an oral health program on domestic violence survivors within community shelters.Crossref | GoogleScholarGoogle Scholar |
Bedos C, Brodeur J-M, Boucheron L, Richard L, Benigeri M, Olivier M, Haddad S (2003) The dental care pathway of welfare recipients in Quebec. Social Science & Medicine 57, 2089–2099.
| The dental care pathway of welfare recipients in Quebec.Crossref | GoogleScholarGoogle Scholar |
British Dental Association (2003) Dental care for homeless people. (British Dental Association: London, UK) Available at www.bda.org/dentists/policy-campaigns/public-health-science/public-health/position-statements/Pages/homeless.aspx [Verified 20 June 2017]
Caton S, Greenhalgh F, Goodacre L (2016) Evaluation of a community dental service for homeless and ‘hard to reach’ people. British Dental Journal 220, 67–70.
| Evaluation of a community dental service for homeless and ‘hard to reach’ people.Crossref | GoogleScholarGoogle Scholar |
Chi D, Milgrom P (2008) The oral health of homeless adolescents and young adults and determinants of oral health: preliminary findings. Special Care in Dentistry 28, 237–242.
| The oral health of homeless adolescents and young adults and determinants of oral health: preliminary findings.Crossref | GoogleScholarGoogle Scholar |
Cohen LA, Manski RJ, Hooper FJ (1996) Does the elimination of Medicaid reimbursement affect the frequency of emergency department dental visits? The Journal of the American Dental Association 127, 605–609.
| Does the elimination of Medicaid reimbursement affect the frequency of emergency department dental visits?Crossref | GoogleScholarGoogle Scholar |
Coles E, Freeman R (2016) Exploring the oral health experiences of homeless people: a deconstruction-reconstruction formulation. Community Dentistry and Oral Epidemiology 44, 53–63.
| Exploring the oral health experiences of homeless people: a deconstruction-reconstruction formulation.Crossref | GoogleScholarGoogle Scholar |
Coles E, Chan K, Collins J, Humphris G, Richards D, Williams B, Freeman R (2011) Decayed and missing teeth and oral-health-related factors: predicting depression in homeless people. Journal of Psychosomatic Research 71, 108–112.
| Decayed and missing teeth and oral-health-related factors: predicting depression in homeless people.Crossref | GoogleScholarGoogle Scholar |
Coles E, Watt C, Freeman R (2013) ‘Something to smile about’: an evaluation of a capacity-building oral health intervention for staff working with homeless people. Health Education Journal 72, 146–155.
| ‘Something to smile about’: an evaluation of a capacity-building oral health intervention for staff working with homeless people.Crossref | GoogleScholarGoogle Scholar |
Collins J, Freeman R (2007) Homeless in north and west Belfast: an oral health needs assessment. British Dental Journal 202, E31
| Homeless in north and west Belfast: an oral health needs assessment.Crossref | GoogleScholarGoogle Scholar |
Conte M, Broder H, Jenkins G, Reed R, Janal M (2006) Oral health, related behaviors and oral health impacts among homeless adults. Journal of Public Health Dentistry 66, 276–278.
| Oral health, related behaviors and oral health impacts among homeless adults.Crossref | GoogleScholarGoogle Scholar |
Daly B, Newton T, Batchelor P, Jones K (2010a) Oral health care needs and oral health-related quality of life (OHIP-14) in homeless people. Community Dentistry and Oral Epidemiology 38, 136–144.
| Oral health care needs and oral health-related quality of life (OHIP-14) in homeless people.Crossref | GoogleScholarGoogle Scholar |
Daly B, Newton T, Batchelor P (2010b) Patterns of dental service use among homeless people using a targeted service. Journal of Public Health Dentistry 70, 45–51.
| Patterns of dental service use among homeless people using a targeted service.Crossref | GoogleScholarGoogle Scholar |
De Palma P, Nordenram G (2005) The perceptions of homeless people in Stockholm concerning oral health and consequences of dental treatment: a qualitative study. Special Care in Dentistry 25, 289–295.
| The perceptions of homeless people in Stockholm concerning oral health and consequences of dental treatment: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
De Palma P, Frithiof L, Persson L, Klinge B, Halldin J, Beijer U (2005) Oral health of homeless adults in Stockholm, Sweden. Acta Odontologica Scandinavica 63, 50–55.
| Oral health of homeless adults in Stockholm, Sweden.Crossref | GoogleScholarGoogle Scholar |
de Pereira M, Oliveira L, Lunet N (2014) Caries and oral health related behaviours among homeless adults from Porto, Portugal. Oral Health & Preventive Dentistry 12, 109–116.
Figueiredo RLF, Hwang SW, Quinonez C (2013) Dental health of homeless adults in Toronto, Canada. Journal of Public Health Dentistry 73, 74–78.
| Dental health of homeless adults in Toronto, Canada.Crossref | GoogleScholarGoogle Scholar |
Figueiredo RLF, Dempster L, Quinonez C, Hwang SW (2016) Emergency Department use for dental problems among homeless individuals: a population-based cohort study. Journal of Health Care for the Poor and Underserved 27, 860–868.
| Emergency Department use for dental problems among homeless individuals: a population-based cohort study.Crossref | GoogleScholarGoogle Scholar |
Ford PJ, Cramb S, Farah CS (2014) Oral health impacts and quality of life in an urban homeless population. Australian Dental Journal 59, 234–239.
| Oral health impacts and quality of life in an urban homeless population.Crossref | GoogleScholarGoogle Scholar |
Freeman R, Coles E, Edwards M, Elliot G, Heffernan A, Moore A (2011) ‘The Oral Health of Homeless People Across Scotland: Report of the Homeless Oral Health Survey in Scotland 2008–2009.’ (University of Dundee, Dental Health Services Research Unit: Dundee, UK)
Gray R (2007) Referral patterns and access to dental services of people affected by homelessness in Dublin, Ireland. Journal of Disability and Oral Health 8, 51–56.
Hill KB, Rimmington D (2011) Investigation of the oral health needs for homeless people in specialist units in London, Cardiff, Glasgow and Birmingham. Primary Health Care Research and Development 12, 135–144.
| Investigation of the oral health needs for homeless people in specialist units in London, Cardiff, Glasgow and Birmingham.Crossref | GoogleScholarGoogle Scholar |
Jaafar N, Jalalluddin R, Razak I, Esa R (1992) Investigation of delay in utilization of government dental services in Malaysia. Community Dentistry and Oral Epidemiology 20, 144–147.
| Investigation of delay in utilization of government dental services in Malaysia.Crossref | GoogleScholarGoogle Scholar |
King TB, Gibson G (2003) Oral health needs and access to dental care of homeless adults in the United States: a review. Special Care in Dentistry 23, 143–147.
| Oral health needs and access to dental care of homeless adults in the United States: a review.Crossref | GoogleScholarGoogle Scholar |
Lashley M (2008) Promoting oral health among the inner city homeless: a community-academic partnership. The Nursing Clinics of North America 43, 367–379.
| Promoting oral health among the inner city homeless: a community-academic partnership.Crossref | GoogleScholarGoogle Scholar |
Luo Y, McGrath C (2006) Oral health status of homeless people in Hong Kong. Special Care in Dentistry 26, 150–154.
| Oral health status of homeless people in Hong Kong.Crossref | GoogleScholarGoogle Scholar |
Major N, McQuistan MR, Qian F (2016) Changes in dental students’ attitudes about treating underserved populations: a longitudinal study. Journal of Dental Education 80, 517–525.
McQuistan MR, Kuthy RA, Qian F, Riniker-Pins KJ, Heller KE (2010) Dentists’ treatment of underserved populations following participation in community-based clinical rotations as dental students. Journal of Public Health Dentistry 70, 276–284.
| Dentists’ treatment of underserved populations following participation in community-based clinical rotations as dental students.Crossref | GoogleScholarGoogle Scholar |
Nebeker CD, Briskie D, Maturo R, Piskorowski W, Sohn W, Boynton J (2014) Michigan dentists’ attitudes toward Medicaid and an alternative public dental insurance system for children. Pediatric Dentistry 36, 34–38.
Parker EJ, Jamieson LM, Steffens MA, Cathro P, Logan RM (2011) Self-reported oral health of a metropolitan homeless population in Australia: comparisons with population-level data. Australian Dental Journal 56, 272–277.
| Self-reported oral health of a metropolitan homeless population in Australia: comparisons with population-level data.Crossref | GoogleScholarGoogle Scholar |
Pluye P, Robert E, Cargo M, Bartlett G, O’Cathian A, Griffiths F, Boardman F, Gagnon M, Rousseau M (2011) Proposal: a mixed methods appraisal tool for systematic mixed studies reviews. (McGill University: Montreal, QC, Canada) Available at http://mixedmethodsappraisaltoolpublic.pbworks.com [Verified 24 August 2017]
Pritchett RM, Hine CE, Franks MA, Fisher-Brown L (2014) Student-led oral health education for the homeless community of East London. British Dental Journal 217, 85–88.
| Student-led oral health education for the homeless community of East London.Crossref | GoogleScholarGoogle Scholar |
Robbins JL, Wenger L, Lorvick J, Shiboski C, Kral AH (2010) Health and oral health care needs and health care-seeking behavior among homeless injection drug users in San Francisco. Journal of Urban Health 87, 920–930.
| Health and oral health care needs and health care-seeking behavior among homeless injection drug users in San Francisco.Crossref | GoogleScholarGoogle Scholar |
Rowan MS, Mason M, Robitaille A, Labrecque L, Tocchi CL (2013) An innovative medical and dental hygiene clinic for street youth: results of a process evaluation. Evaluation and Program Planning 40, 10–16.
| An innovative medical and dental hygiene clinic for street youth: results of a process evaluation.Crossref | GoogleScholarGoogle Scholar |
Seirawan H, Elizondo L, Nathason N, Mulligan R (2010) The oral health conditions of the homeless in downtown Los Angeles. Journal of the California Dental Association 38, 681–688.
Simons D, Pearson N, Movasaghi Z (2012) Developing dental services for homeless people in East London. British Dental Journal 213, E11
| Developing dental services for homeless people in East London.Crossref | GoogleScholarGoogle Scholar |
Van Hout MC, Hearne E (2014) Oral health behaviours amongst homeless people attending rehabilitation services in Ireland. Journal of the Irish Dental Association 60, 144–149.
