The aim was to explore and compare oral health and need for dental treatment in newly arrived refugees from the Middle East and Africa to Norway. Oral examination and structured interviews were performed with attending interpreters. Associations between origin and measures for oral health were studied with multiple linear regression. Half of the refugees (n = 132) reported oral impacts on daily performances (OIDP) and mean number of decayed teeth (DT) was 4.3 (SD 3.5). Refugees from the Middle East had more DT (1.38, p = 0.044), higher sum of decayed, missing and filled teeth (DMFT) (3.93, p = 0.001) and lower OIDP-score (- 3.72, p = 0.026) than refugees from Africa. Refugee oral health is generally poor, with more extensive challenges in refugees from the Middle East. However, few missing teeth, and manageable caries-gradient at the time of registration indicate that most refugees have the prerequisites for a good dentition, provided they get the necessary treatment.

Torture victims often show symptoms of dental anxiety when receiving dental care, but little systematic research is available. The purpose of this study was to explore torture experiences, symptoms of post‐traumatic stress disorder (PTSD), and dental anxiety in refugees in Norway and to test the hypothesis that refugees with torture experiences are more prone to dental anxiety than refugees with no such experiences. A total of 173 refugees were interviewed shortly after an oral examination. The Modified Dental Anxiety Scale (MDAS) and the Harvard Trauma Questionnaire‐PTSS16 were administered verbally through attending interpreters. Among torture victims (47%, n = 81), the prevalence of torture experiences involving mouth or teeth was 35% and 23%, respectively. Harvard Trauma Questionnaire mean sum scores were statistically significantly higher in torture victims (34.3 vs. 24.8). Torture survivors report a larger number of symptoms of PTSD, and dental anxiety shows a higher prevalence in refugees reporting PTSD symptoms than in refugees who do not report such symptoms. When analysed using logistic regression models, the data showed the odds of high levels of dental anxiety being 6.1 times higher in refugees with torture experiences compared with other refugees and 9.3 times higher in torture victims with PTSD symptoms. Oral health professionals should be aware of these associations when providing dental care to refugees. The hypothesis that tortured refugees are more prone to dental anxiety is supported.

Introduction: The flow of refugees towards Europe over the past decade has placed increased demands on the health care services. A significant proportion of refugees have been subjected to torture involving their mouth or teeth, still the importance of oral health challenges is often overlooked or underestimated in the rehabilitation of torture victims. In this qualitative study, we set out to explore the processes that complicate torture victims’ ability to engage in and tolerate dental procedures. Methods: Ten resettled refugees with experience of torture were recruited among patients affiliated with specialized clinics for oral health rehabilitation in Norway. Data were collected through semi-structured exploratory interviews, and analyzed using a qualitative content analysis approach. Results and discussion: We present an exploration of what we have called the social and material anatomy of the triggering event; the process through which trauma-related reactions are produced in torture victims in the course of undergoing dental treatment. All professionals who work with torture survivors should be aware that these individuals often suffer from oral health problems that may affect both their physical and their psychological quality of life. However, although dental treatment is essential, it may still represent a major challenge. Our data suggest, we propose, that dental treatment often involves an experience being suspended, albeit temporarily, in an objectified position, acted on by subjects capable of producing deeply undesirable mental, emotional or bodily states. Three main categories emerged as the most prominent factors with such an agentic capacity: 1) pain, 2) traumatic memories and 3) the dentist. Submitting to dental treatment hence requires the patient’s willingness to give in to the actions of these factors, and avoiding treatment may therefore, in this situation, represent a means of retaining control.

No abstract

No abstract