New study discovers homeless dental problems 

25/11/2013 00:00 
A new study has discovered that many homeless people across the capital experience serious dental problems and face considerable barriers in receiving NHS treatment.

The survey carried out with over 150 currently and formerly homeless people found high levels of dental problems such as pain, tooth loss and bleeding gums which had a significant impact on quality of life.
Many of these problems continue into the individuals’ recovery and resettlement.  Almost 40 per cent of those surveyed said that their dental problems affected their overall satisfaction with life, with many reporting difficulties with chewing and eating, which impacted on social interaction.

The research, which was led by Pathway, the homeless health charity, and UCLH’s Eastman Dental Hospital, also highlighted the potential costs both to individuals and to health services from inadequate access to dental advice, preventative care, and timely treatment.

Dr Ulpee Darbar, Clinical Director at Eastman Dental Hospital said: “This project has opened our eyes as service providers to the real need and issues that homeless people face in accessing dental care but more importantly the impact this can have on their recovery and general well being.”

“We often tend to forget what we do not see and this project brought to the forefront that there are key groups of people where kindness, support and effective care can make a difference to their lives.  The Eastman Dental Hospital hopes that it can continue this partnership working to bring to the forefront the challenge faced by this group of people and work with commissioners to help address this need.”

The study also showed that, once in contact with good services, the experience of homeless people is more often positive than negative, and many remain in contact with services once they have been registered. 

Responses also showed the need to raise awareness of the benefits of regular dental care, how to access treatment, and what to expect from treatment.  Over 50 per cent reported that NHS dentistry was ‘hard to find’ and accessing it was difficult.

In a second part of the project, 14 people with significant histories of homelessness were seen by a clinician at the Eastman Dental Hospital who completed detailed clinical assessments of each patients dental health and developed treatment plans for all of them.

Many respondents said how important restorative dentistry could be to build their confidence, enable them to eat better, take away chronic pain, and support them to better interact with other people.

Effective and improved access to dental care for homeless people, together with early prevention and timely interventions will also help ease the risk of this burden on the NHS.  Good access to dental service could also play a part in helping homeless people re-build their lives after coming off the street.  The London Housing Foundation, who funded this initial study, have now indicated they are interested in supporting a larger follow up.

Formerly homeless patient Bean said: “If you’re talking to someone and they’ve got brown teeth with big gaps in that’s what you notice, you don’t notice the rest of their face - but someone with nice, clean white teeth then you look at the whole person.” 

He also added that “you shouldn’t underestimate the level of fear involved in people going to the dentist”. Bean is being supported to access treatment.

Pathway, based at UCLH, is giving homeless people access to proper healthcare and saving the NHS hundreds-of thousands-of-pounds in the process. 

Alex Bax, CEO of Pathway said “This project builds on our experience of working in partnership with homeless people and NHS services to transform health outcomes for this disadvantaged and vulnerable group.  We believe this is the first study of its kind in England, and we are committed to influencing and collaborating with a range of partners to achieve a step-change in the accessibility of services.  This is critical to restore dental health for people who have not been able to access the services they need when they need them – and is an important part of supporting recovery from the long-term impacts of homelessness and exclusion.”

For more information about Pathway visit

London Housing Foundation (LHF) and Inclusion Health funded the initial project.  LHF has now agreed to fund an expanded study to examine ways to improve access to dentistry care, influence NHS services, and support homelessness and health services to provide well-informed support to enable more people to benefit from dental advice and care.


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