The oral health of refugees: Issues and challenges arising from a case series analysis

Abstract

Community Dent Oral Epidemiol. 2020;48:195-200. | 195 wileyonlinelibrary.com/journal/cdoe | INTRODUC TI ONRefugees constitute a heterogeneous population. Coming from different backgrounds, they experience, in their own and hosting countries, a wide range of practices that may affect their health. 1 It is generally acknowledged that refugees have greater health needs and concerns than most immigrants, partly arising from the refugee experience and resettlement process. 1 In situations of political and social uncertainty, children and adolescents are at higher risk of psychological instability and trauma, subsequently warranting special attention and care to address their healthcare needs. 2,3 Refugees face many difficulties when seeking healthcare services. These include poverty, discrimination and fragmented families. 4 In addition, a lack of adequately trained and understanding healthcare providers, facilities and a shortage of available funding for health services may limit their accessibility to appropriate health care. 1,5 Thus, highlighting the impact of poor oral health on quality of life is of vital importance, especially since such individuals are Abstract Objectives: Little is known of the oral health of refugees globally. The objective of this study was to characterize the oral health and care-seeking behaviours of refugees by investigating patterns of dental services provided to Syrian refugees in Jordan and their association with their oral health status. Methods:Clinical records from 444 patients who had received dental treatment over a 9-month period were retrieved and analysed. Collected data included gender, age and the type and number of treatment procedures provided for each patient. Results:Of the total sample (51.8% female; 48.2% male; aged 18-60 years), pain was the most common presenting complaint (73.0%), with poor aesthetics (17.1%) the second most common presenting complaint. About 63.3% of patients received only one procedure due to patients' lack of follow-up. Over half (54.5%) of dental treatments carried out were extractions, 74.1% of which were due to dental caries; 27.4% were fillings. Endodontic treatment was the least provided procedure (18.2%). Conclusions:The oral health status of Syrian refugees is a major concern, given the often-deplorable living conditions in camps and limited, often inadequate access to oral healthcare services. This situation dramatically negatively affects a refugee's oral health. There is an urgent need to provide targeted dental services for this at-risk population. Additional research is warranted on refugees worldwide, and on the provision of appropriate interventions to enable optimal oral health for this population.

Satisfaction with healthcare services among refugees in Zaatari camp in Jordan

“…However, no studies have evaluated refugee satisfaction regarding provided services. Limited availability/access to basic health services, including dental care, nutrition, immunization, preventive care and chronic disease management, is a major challenge to refugees [ 7 , 15 ]. It is important to provide data to guide service provision and clinical management according to patient-based approaches.…”

“…The present study found that most elements under human and physical health resources range from acceptable to very satisfied, except for ‘ease of access to general/oral health facilities’ and ‘availability of all dental services’. It has been reported previously that the attitude of non-attendance or delays in obtaining dental/medical treatment are strongly associated with accessibility, income, availability of healthcare facilities and perception of the need for routine dental care; all of which are major concerns for the refugee population [ 7 , 26 ]. Furthermore, extended waiting times for emergency and routine dental treatment are associated with higher rates of amplified deterioration of teeth [ 27 ].…”

“…Furthermore, extended waiting times for emergency and routine dental treatment are associated with higher rates of amplified deterioration of teeth [ 27 ]. All of the factors listed above result in delay in pursuing dental care, and therefore leading to an extraordinary percentage of dental extractions [ 7 , 26 ]. Consequently these two elements have negative and irreversible consequences on the health of this population, warranting an effective and targeted service with increased capacity.…”

“…Consequently these two elements have negative and irreversible consequences on the health of this population, warranting an effective and targeted service with increased capacity. Additionally, modes of transportation were mainly on foot or by bicycle for nearby sectors, while for distances ranging from 4–5 km transportation by pickup trucks was shared for a fee, this factor again makes accessibility to certain clinics in different districts very difficult [ 7 ]. Regarding the available dental treatment, it has been reported that only basic restorative treatment and simple extractions are the most commonly available dental treatment in the camp [ 7 , 26 ].…”

“…Post-migration stress has a negative effect on (HRQOL) among newly arrived refugees and existing evidence indicates that this population has substantially higher oral disease levels than the general population [ 7 ].…”