Evaluation of a community dental service for homeless and 'hard to reach' people

Abstract

Crucially, providers must acknowledge that the patients are vulnerable. A successful service needs to be informal, adapt to patient needs and accommodates chaotic lives.

Barriers and enablers to accessing dental services for people experiencing homelessness: A systematic review

“…Mental health issues and psychosocial factors can exacerbate the prevalent dental anxiety/fear and further inhibit dental attendance . Furthermore, dependency issues (ie, drugs, alcohol) lead to self‐neglect and further decrease the priority placed upon oral health …”

“…A feeling of lack of control contributes to homeless people feeling anxious during dental appointments . Embarrassment in relation to the condition of their teeth and the subsequent impact on self‐esteem can itself act as a barrier …”

“…An individual's unwillingness to change their behaviours, and mistrust/dislike of healthcare services/professionals, also acts as barriers to dental attendance for homeless people . Some homeless people also feel discriminated or stigmatized by dental professionals and/or receptionists.…”

“…Compassionate communication which means dental staff being approachable, friendly, supportive, sympathetic, not being easily shocked and having an understanding of the difficulties that homeless people encounter appears to be important qualities for staff dealing with homeless people and is important in determining the success of any service provided …”

“…Homeless people are sometimes refused ongoing care at dental practices and some clinics, or dentists are hesitant to accept homeless people for treatment . Reasons reported for precluding homeless people from “registering” or attending included lack of a fixed address (ie, having a hostel address), the practice being full, or existence of a waiting list, the practice taking only private patients and patients being on welfare benefits .…”