Search

ObjectivesThe present study aimed to identify strategies to improve oral health behaviours as well as access to and provision of dental care for people experiencing homelessness.

IntroductionFollowing the World Health Organisation declaration of COVID-19 as a global pandemic, routine dental care in the UK ceased, and Urgent Dental Care centres (UDCs) were established to offer remote and face-to-face urgent dental treatment for those in need.

IntroductionSubstantial evidence has established associations between oral health and chronic diseases, mediated by common risk factors and inflammatory processes. Dental professionals are aptly positioned to screen for cardiovascular disease and diabetes high-risk indicators. This article presents a service evaluation of two dental practices delivering health screening in dental practice, and a call to action for the wider profession.

People experiencing homelessness have unmet healthcare needs often related to chronic health conditions and injury. Nurses are often the first and only point of contact for people experiencing homelessness accessing healthcare. However, education that prepares them to meet the needs of this vulnerable population is limited.

People experiencing homelessness are less likely to access healthcare, particularly primary and preventive care. Nurses are well placed to improve access to healthcare for this vulnerable population.

Introduction Poor oral health and barriers to accessing dental services are common among people experiencing social exclusion. This population experience a disproportionate and inequitable burden of oral disease. A small number of dental services have published models of care that target this population, but no national surveys have been conducted.

AimsTo investigate factors influencing oral health behaviours and access to dental services for asylum seekers and refugees (ASRs).

The sexual health needs of young people experiencing homelessness in the UK have not been researched adequately. This study aimed to examine knowledge and attitudes around sexual health and contraceptive use amongst this vulnerable group to develop suitable models of care in the community. A qualitative ethnographic case-study following Burawoy's extended case method was used. Semi-structured interviews with 29 young people experiencing homelessness and five key workers in London hostels were carried out together with ethnographic observations and analysis of documentary evidence. Thematic analysis was undertaken. Demographic data were collected. Three significant themes were identified: risks and extreme vulnerability, relationships and communication difficulties and emergence of a culture of homelessness. Young people experiencing homelessness require specialist delivery of sexual health care in safe surroundings. Initial care should focus on assessment of basic needs and current state of being. Establishing trusting relationships and considering ongoing vulnerability, can help promote meaningful and personalised sexual healthcare both at policy and practice level.

IntroductionWhile routine dentistry was suspended during the COVID-19 pandemic, Urgent Dental Care centres (UDCs) were established to support patients with urgent dental needs.

IntroductionPeople who experience homelessness face disproportionately poor reproductive health and adverse pregnancy outcomes, including but not limited to unintended pregnancy, abortion, low birth weight and preterm birth, as well as a higher risk of sexually transmitted infections (STIs). Precarious living conditions are known to contribute to poor uptake and engagement with sexual and reproductive healthcare (SRH) for this population.AimTo identify and understand the perceived barriers and facilitators for accessing and utilising SRH for people who experience homelessness from their perspective, and the perspective of support staff/volunteers and healthcare professionals.MethodsElectronic databases and online sources were searched. Two reviewers independently carried out the screening, data extraction, critical appraisal, data synthesis and thematic analysis of findings.ResultsFollowing deduplication and screening, 23 papers/reports were considered eligible for the review. Barriers for people experiencing homelessness to accessing and utilising SRH were identified within the themes of complexity, feelings and knowledge (ie, individual-level factors), as well as patient/provider interaction and healthcare system (ie, organisational factors). Facilitators were identified within all of the above themes except for complexity.ConclusionsBoth population characteristics and attributes of the healthcare system influence access and utilisation of SRH by people experiencing homelessness. Given the complexity of living conditions associated with homelessness, greater efforts to improve access should be placed on healthcare systems and aspects of care delivery. This systematic review highlights current gaps in the literature and provides recommendations for enhancing future research and practice to meet the needs of this vulnerable group more effectively.

A qualitative study

Objective: To examine the impact of treating carious teeth on children's and adolescents' anthropometric outcomes. Basic research design: Four electronic databases and four electronic clinical trials registries were searched. Two reviewers independently conducted the screening, data extraction and critical appraisal. The Cochrane Risk of Bias Tool for Randomised Controlled Trials was used to assess the risk of bias in the included studies. Results: The searches yielded 399 potential studies. Following deduplication and screening of the papers, four were considered eligible for inclusion of which two referred to the same study. None of the included studies was found to have a high risk of bias in any of the domains. However, performance bias was deemed of unclear risk in all studies. One of the studies found that following extraction of pulpally involved teeth, underweight children exhibited a statistically significant improvement in their weightfor- age (change in mean=0.26; p<0.001) and BMI-for-age z scores (change in mean=0.52, p<0.001) and had a significant weight gain (change in mean=1.2; p<0.001). Two studies showed that dental intervention did not have a significant effect on anthropometric outcomes. Treatment of caries significantly improved children's oral health-related quality of life in two studies. Conclusions: The evidence into the impact of treating carious teeth on children's growth is mixed and inconclusive. However, there is consistent evidence that treatment of severely carious teeth can significantly improve children's oral health-related quality of life. Oral health promotion and strategies to screen for oral health problems and widen dental access should be considered as part of integrated public health programs targeting children. [ABSTRACT FROM AUTHOR]

Homelessness overlapping with substance use and offending is described as severe and multiple disadvantage (SMD). People experiencing SMD have poor oral health along with high levels of related behaviours such as substance use, smoking, and poor diet. Existing evidence largely describes the prevalence of oral health problems, substance use, and smoking in SMD groups. Little is known about interventions that can address these conditions in SMD groups. We aimed to review the effectiveness and cost-effectiveness of interventions on oral health and related health behaviours in adults experiencing SMD.

People with experience of homelessness commonly suffer from poor oral health and are likely to have low-level engagement with dental services. 'Teeth Matter' was a pilot study developed to examine whether peer education could result in improved plaque management among people who are experiencing homelessness. Based on the experience gained from developing and implementing the study, and taking into consideration the views of everyone involved, this paper provides a list of suggestions and resources that can be used to improve engagement of this population with oral health promotion activities. Some of the learning points are also applicable in the clinical setting.

Introduction People who experience homelessness have poor oral health and limited access to dental services. Aim To examine whether 'peer education' could yield improved plaque management among people experiencing homelessness. Methods A quasi-experimental, one-group pre-test-post-test study was conducted, with follow-up at one and two months. Participants were living in temporary accommodation in Plymouth, UK. Plaque levels were assessed using the simplified oral hygiene index. A questionnaire and the oral health impact profile (OHIP-14) were administered. Patient satisfaction and barriers to dental care were explored by interviews. ResultsThe baseline sample included 24 people with a mean age of 36.88 ± 10.26 years. The mean OHIP-14 score was 25.08 ± 19.56; finding it uncomfortable to eat and being embarrassed attracted the highest values (2.46 ± 1.53 and 2.33 ± 1.63, respectively). Plaque levels decreased by month one and month two, though the changes were not statistically significant. Positive changes in confidence in toothbrushing at month two were identified (p = 0.01). ConclusionExperiencing pain and the opportunity to access treatment were key drivers of study participation. The study indicated that it is feasible to conduct oral health promotion projects for people in temporary accommodation. Adequately powered studies examining the impact of peer education on improving homeless people's oral health are warranted.

Objective: To examine the spatial clustering of obesity and dental caries in young children in Plymouth, United Kingdom, to evaluate the association between these conditions and deprivation, and explore the impact of neighbourhood-level characteristics on their distribution. Basic research design: Cross-sectional study analysing data from the National Child Measurement Programme (N=2427) and the Local Dental Health Survey (N=1425). The association of deprivation with weight status and caries was determined at individual and area level, using ANOVA and Poisson models. The overall spatial clustering was assessed using a modified version of the Global Moran's I, while clusters were located through Local Indicators of Spatial Association. Spatial autocorrelation was assessed using the variograms of the raw values. Log-linear Poisson models were fitted to assess the significance of neighbourhood characteristics on overweight/obesity and caries distribution. Results: At an individual level, deprivation was not associated with BMI z-scores but was a significant predictor of caries (p<0.05). However, at area level, deprivation related to the rates of both conditions. A significant positive autocorrelation was observed across neighbourhoods for caries. The variograms suggested spatial autocorrelations up to 2.5 km and 3 km for overweight/obesity and caries, respectively. Among several neighbourhood characteristics, the proportion of people on benefits was found to be a significant predictor of caries rates. Conclusions: Our results underline the importance of considering geographic location and characteristics of the broader environment when developing strategies to target obesity and caries. [ABSTRACT FROM AUTHOR]