Oral health needs of the homeless

Aim: The aim was to assess the oral health needs of a homeless population residing in North and West Belfast Health and Social Services Trust area, in order to determine levels of unmet need and allow recommendations for service delivery to be made. Method: A sample of single homeless people was gathered using a snowballing sampling technique. Fourteen hostels located in North and West Belfast were visited in tandem with the homeless healthcare co-ordinator. All consenting participants were asked to complete a detailed medical history questionnaire and a questionnaire to assess their health and psycho-social needs, dental anxiety and oral health-related quality of life. All participants received an oral examination. Results: Three hundred and seventeen homeless people consented to take part. Two hundred and sixty-seven (84%) were male. Thirty-three percent of participants had mental health problems including psychotic illness, depression and anxiety. Forty-three percent of the sample stated they were addicted to alcohol and 3% were registered injecting drug users. Five percent (16) of the sample had soft tissue swellings of which two were found to be oral cancer. The participants had a mean D3cvMFT of 16.16 (95% CI: 15.71, 17.46). Seventy-fi ve percent of the sample had bleeding gums and calculus; however only 4% had pocket depths of 6 mm or more. Dental anxiety status was related to dental disease experience which impacted negatively on quality of life. Forty-seven percent of the participants felt at least occasionally self-conscious and/or felt ashamed by the appearance of their teeth. Conclusions: Health and psychosocial factors associated with being homeless must be incorporated into the delivery of context-sensitive oral healthcare for this socially excluded population.