Assessing the Oral Health of the Homeless Population in Central Massachusetts
DOI:
https://doi.org/10.65539/a8wz2871Keywords:
oral health, homelessness, health disparities, dental care access, MedicaidAbstract
Oral health conditions are common yet highly preventable, and they disproportionately affect socioeconomically disadvantaged communities. This cross-sectional survey of 144 homeless and housing-insecure adults in central Massachusetts assessed oral health status, access to dental and primary care, and resource needs. Participants were far more likely to have a primary care provider than a regular dentist, and poor oral health was strongly associated with poor overall health. Respondents most frequently reported needing dentists who accept public insurance, basic dental supplies, and transportation to appointments. The findings highlight opportunities to improve oral health for people experiencing homelessness through better supply access, case management, and integration of oral health into primary care.
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Peres MA, Macpherson LMD, Weyant RJ, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–260. DOI: https://doi.org/10.1016/S0140-6736(19)31146-8
Vos T, Abajobir AA, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858. DOI: https://doi.org/10.1016/S0140-6736(18)32279-7
American Dental Association. Action for Dental Health: Bringing Disease Prevention into Communities. 2013.
Lee Y. Diagnosis and prevention strategies for dental caries. J Lifestyle Med. 2013;3(2):107–109.
U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: National Institute of Dental and Craniofacial Research; 2000.
Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res. 2014;93(7 Suppl):20S–28S. DOI: https://doi.org/10.1177/0022034514537828
Matsuyama Y, Aida J, Tsuboya T, et al. Are lowered socioeconomic circumstances causally related to tooth loss? A natural experiment involving the 2011 Great East Japan earthquake. Am J Epidemiol. 2017;186(1):54–62. DOI: https://doi.org/10.1093/aje/kwx059
Schwendicke F, Dörfer CE, Schlattmann P, et al. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res. 2015;94(1):10–18. DOI: https://doi.org/10.1177/0022034514557546
Costa SM, Martins CC, Pinto MQC, et al. Socioeconomic factors and caries in people between 19 and 60 years of age: an update of a systematic review and meta-analysis of observational studies. Int J Environ Res Public Health. 2018;15(8):1775. DOI: https://doi.org/10.3390/ijerph15081775
Klinge B, Norlund A. A socio-economic perspective on periodontal diseases: a systematic review. J Clin Periodontol. 2005;32(Suppl 6):314–325. DOI: https://doi.org/10.1111/j.1600-051X.2005.00801.x
Conway DI, Petticrew M, Marlborough H, et al. Socioeconomic inequalities and oral cancer risk: a systematic review and meta-analysis of case–control studies. Int J Cancer. 2008;122(12):2811–2819. DOI: https://doi.org/10.1002/ijc.23430
Como DH, Stein Duker LI, Polido JC, et al. The persistence of oral health disparities for African American children: a scoping review. Int J Environ Res Public Health. 2019;16(5). DOI: https://doi.org/10.3390/ijerph16050710
Braveman P, Egerter S, Williams DR. The social determinants of health: coming of age. Annu Rev Public Health. 2011;32:381–398. DOI: https://doi.org/10.1146/annurev-publhealth-031210-101218
Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: US Dept of Health and Human Services; 2019.
Henry M, de Sousa T, Roddey C, et al. The 2020 Annual Homeless Assessment Report (AHAR) to Congress. Washington, DC: U.S. Department of Housing and Urban Development, Office of Community Planning and Development; 2020.
Ferenchick GS. The medical problems of homeless clinic patients: a comparative study. J Gen Intern Med. 1992;7(3):294–297. DOI: https://doi.org/10.1007/BF02598086
Baggett TP, O’Connell JJ, Singer DE, et al. The unmet health care needs of homeless adults: a national study. Am J Public Health. 2010;100(7):1326–1333. DOI: https://doi.org/10.2105/AJPH.2009.180109
Clark M. Homelessness and Oral Health. U.S. Department of Health and Human Services; 1999. Available at: https://www.mchoralhealth.org/PDFs/OHHomelessfactsheet.pdf. Accessed July 19, 2021.
Allukian M Jr. Oral health: an essential service for the homeless. J Public Health Dent. 1995;55(1):8–9. DOI: https://doi.org/10.1111/j.1752-7325.1995.tb02323.x
Mago A, MacEntee MI, Brondani M, et al. Anxiety and anger of homeless people coping with dental care. Community Dent Oral Epidemiol. 2018;46(3):225–230. DOI: https://doi.org/10.1111/cdoe.12363
U.S. Conference of Mayors. A Status Report on Hunger and Homelessness in America’s Cities. Washington, DC; 1998.
United States Interagency Council on Homelessness. Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. Washington, DC; 2011.
Migiro G. Largest Cities in New England. WorldAtlas.com. Updated December 6, 2019. Accessed July 13, 2021.
Central Massachusetts Housing Alliance. Point-in-Time Count MA-506 Worcester City & County CoC. Worcester, MA: US Department of Housing and Urban Development; January 29, 2020.
IBM Corp. IBM SPSS Statistics for Windows. Version 27.0. Armonk, NY: IBM Corp; 2020.
The Pew Charitable Trusts. A Path to Expanded Dental Access in Massachusetts: Closing Persistent Gaps in Care. 2017. Available at: https://www.pewtrusts.org/-/media/assets/2017/01/a_path_to_expanded_dental_access_in_ma.pdf. Accessed July 29, 2021.
Villamarin V, Silk H. Oral health and local disparities. Worcester Med. 2021;90(1):5–6.
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