Last updated: 21 October 2024
What is the inclusive dentistry report?
- It explains why people experiencing homelessness might struggle to maintain good oral health and access dental services. This includes feedback from an Experts by Experience focus group.
- It looks at the different types of NHS dental service and how people experiencing homelessness can be supported to receive treatment.
- It investigates alternative models of dental care, developed specifically with people experiencing homelessness in mind.
- It offers recommendations as to how access to dental services can be improved.
Who is it for?
This report is for anyone commissioning or designing dentistry services and wanting to make them more inclusive for people who are homeless, and for homelessness workers advocating for inclusion health.
Barriers to treatment
The difficulties faced by people experiencing homelessness in accessing dental services can be significant. They range from a lack of information about how services work, to being refused care. In common with other socially excluded groups, many people experiencing homelessness have endured trauma, which can also affect their ability to seek and receive treatment.
It’s getting more difficult to find an NHS dentist and many lists are full. I’ve tried 4 different dentists in my local area, with no luck.
Seeking treatment
To further explore these difficulties and how they might be overcome, we held a focus group with Experts by Experience with direct experience of homelessness. Participants spoke about how they felt that dental services were inaccessible to them, and what came across strongly was:
- a lack of clarity on entitlement to NHS dental treatment
- the belief they needed to provide ID or a current address to sign up with a dental surgery
- digital exclusion, eg the requirement to sign up and/or complete forms online
- the attitude of some dental practice staff and the feeling they were being judged for experiencing homelessness
- the impact of the increased risk of things like anxiety and unresolved trauma on accessing dental care
- inadequate training for dentists and front facing staff in trauma and psychologically informed approaches and in understanding the complexities faced by people experiencing homelessness.
Key recommendations for better provision
- It is important to encourage collaboration between VCSE organisations, dentists and local commissioners.
- Alternative funding streams and flexible commissioning should be explored. (Alternative models are summarised below.)
- Support through peer and/or link worker advocacy helps people experiencing homelessness to access and complete dental treatment.
- Practical guidance and information are a must.
There should be signposting by surgeries who cannot see you due to the waiting list, with advice on where you can be seen.”
Key oral health messages
- Brush teeth twice a day with a toothpaste containing fluoride
- Brush for two minutes
- Spit don't rinse
- If you want to use mouthwash, use it at a different time to brushing
- Cut down on sugary snacks, foods and drinks
- See your dentist as often as they recommend
- If you smoke or drink alcohol then going to the dentist is even more important. If needed, seek support to help stop smoking and limit alcohol intake.
