Considerations in establishing a dental program for the homeless

Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model

India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries (adding each of these terms in a sequential order). Based on the review of the programs successfully implemented in developed countries, we propose a model to cater to the basic oral health needs of an extensive underserved population in India that may be pilot tested. The increasing dental manpower can best be utilized for the promotion of oral health through mobile and portable dental services. The professional dental organizations should have a strong motive to translate this into reality.

Dental health of homeless adults in Toronto, Canada

OBJECTIVES

This study aimed to assess the oral health status of the Toronto adult homeless population; to learn how they perceive their own oral health; and to correlate the presence of oral disease with length of homelessness and unemployment.

METHODS

This cross-sectional descriptive study collected data from 191 homeless adults who were randomly selected using a stratified cluster sample at 18 shelters. A questionnaire and clinical oral examination were conducted with participants.

RESULTS

The mean Decayed/Missing/Filled Teeth (DMFT) score of the subjects was 14.4 (SD = 8.1). Only 32% of them had visited a dentist during the last year, 75% believed that they had untreated dental conditions, and 40% had their last dental visit for emergency care. The clinical oral examination observed that 88% needed fillings, 70% periodontal, 60% prosthodontic, and 40% emergency treatment.

CONCLUSION

Homeless adults in Toronto have poor oral health, significant oral health treatment needs, and a lack of access to dental care.

Oral health status of homeless people in Hong Kong

The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT = 3.2, MT = 5.2, FT = 0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.

Oral health needs and access to dental care of homeless adults in the United States: a review

The homeless population in the United States is one of great diversity that continues to increase in number. Although data on the oral health status of individuals who are homeless is limited, studies consistently report both the perception and clinical evidence of dental needs among this population as well as a low utilization rate for dental services. This article reviews the oral health needs of people who are homeless as reported in literature, barriers to receiving dental care, and methods used to deliver dental care to this population. Many rehabilitation centers for adults who are homeless consider the establishment and maintenance of a state of good general and oral health as a priority and a key factor in helping homeless adults to return to the workforce and mainstream society.

Mobile and portable dentistry: alternative treatment services for the elderly

With the rapidly expanding geriatric population in the United States, the demand for geriatric dentistry is rising. With the financial, transportation, and motivational barriers the geriatric population faces, it can be difficult for them to seek dental treatment in a traditional setting. Mobile and portable dental units can be used as alternative methods to provide dental care to the geriatric population. Mobile and portable dental units offer advantages such as providing community outreach, increasing personal satisfaction for geriatric clients and dental professionals, and providing dental care to those who would otherwise not receive treatment due to some of the barriers. Although mobile and portable dental units are ideal for long-term facilities, disadvantages do exist in implementing the use of these systems. These include the initial cost of implementing such a unit, limitation of treatment options, the number of clients seen in a day, and maintenance for the unit. Until more research can be done to find ways to improve the quality of dental care for the geriatric population, these units seem to be a reasonable alternative to the traditional approach to providing the elderly with the dental care they require.