The dental health of Gypsies and Travellers is negatively impacted upon by socio-cultural barriers. We present dental-relevant results of a larger project comprising several systematic reviews into Gypsy/Traveller healthcare. We report on empirical studies concerning access to, and engagement with, dental services. By determining activities and methods currently aimed at improving dental services, we offer a critical position on issues such as discrimination, trust and awareness.
Key databases were searched to identify publications relating to Gypsy/Traveller communities’ access to healthcare. Review eligibility relied on satisfying five criteria: Empirical findings were reported; Adequate focus on Gypsy/Traveller communities; Adequate focus on healthcare service engagement; English language publication; and, Publication date 2000-onwards. Of 121 publications included, 24 include findings related to dental health. Concepts and categories were identified and developed through open coding.
Gypsies/Travellers priorities may be on immediate (non-dental) problems rather than prevention. Mobility of these communities conflicts with systems providing courses of treatment in a fixed practice. This affects access to records, practice registration and increases costs in a community who may also self-treat and experience treatment anxieties. It also limits dentists’ capabilities in working with these communities and the development of trusting engagements that are responsive to issues such as gender, timekeeping, and literacy. Programmes such as outreach and drop-in services, multi-agency treatments and centralised/hand-held dental records are under-explored as potentially beneficial to dental health for this community.
Understanding non-medical, structural issues is vital to developing an informed approach to providing fit-for-purpose healthcare solutions. However, how interventions are evaluated within a context of lifetime healthcare inequality are yet to be clarified. Future investigation needs to consult with Gypsy/Traveller communities and engage with both their heterogeneity and similarities with wider populations and explore how engagement with, and trust in, health services can be improved.