Barriers and facilitators to dental care access among asylum seekers and refugees in highly developed countries: a systematic review

Abstract

Background Dental diseases are prevalent among asylum seekers and refugees (ASRs). Despite significant treatment needs, access to dental care in host countries is often limited. The aim of this systematic review was to identify the barriers and enablers to dental care access for ASRs in host countries of very high development. Methods Five health and social care databases and eight grey literature sources of information were searched. The Critical Appraisal Skills Programme tool was used to critically appraise included studies. Thematic analysis was undertaken to identify common themes. These were then deductively organised according to Penchansky and Thomas’s modified access model. All review stages were conducted by two independent reviewers. Results Nine papers were included in the review. ASRs encounter significant challenges to accessing dental care in their host countries. These include affordability, communication difficulties, insufficient interpretation, limited knowledge of the healthcare systems and healthcare rights, and negative encounters with healthcare teams. The views and experiences of dental care teams providing care to ASRs were explored in only one study. Conclusions Both population and healthcare characteristics influence access to dental care for ASRs. Affordability, awareness and accommodation are most frequently described as barriers to dental access for this population. The diverse needs of this population need to be recognised by policy makers, commissioners and practitioners alike. Cultural competence needs to be incorporated into dental services and any interventions to improve access to dental care for this population. Registration PROSPERO- International prospective register of systematic reviews (CRD42019145570).

Oral Health Status and Dental Problems Among the Refugees in Karatepe Refugee Camp in Lesvos, Greece: a Cross-sectional Study

“…Through the results of this study, nationality and the origin of the patient seemed to play a signi cant role in the oral health status, as patients from Afghanistan and Syria seemed to have signi cantly higher DMFT average value compared to other nationalities, the explanation of this result need further investigation and data collection as many factors can determine the oral health status like socioeconomic status, the trends and tradition regarding oral health hygiene, and the length of the route taken to reach Europe (8, 15, 25, 28), the result of our study agrees with another research which found signi cant difference in oral health between refugees from middle east compared to refugees from Africa, as refugees from middle east had worse oral health status (29), and the previous research explained this result because of the different diet as the African diet is low in fat and sugar, and the habit of brushing teeth, for example, tooth-brushing was a daily habits for all African participants in the previous study (29,30).…”

Oral Health Status And Dental Problems Among The Refugees In Karatepe Refugee Camp In Lesvos, Greece: A Cross-Sectional Study

“…Through the results of this study, nationality and the origin of the patient seemed to play a signi cant role in the oral health status, as patients from Afghanistan and Syria seemed to have signi cantly higher DMFT average value compared to other nationalities, the explanation of this result need further investigation and data collection as many factors can determine the oral health status like socioeconomic status, the trends and tradition regarding oral health hygiene, and the length of the route taken to reach Europe (8,15,25,28), the result of our study agrees with another research which found signi cant difference in oral health between refugees from middle east compared to refugees from Africa, as refugees from middle east had worse oral health status (29), and the previous research explained this result because of the different diet as the African diet is low in fat and sugar, and the habit of brushing teeth, for example, tooth-brushing was a daily habits for all African participants in the previous study (29,30).…”

A systematic literature review of service-related research on refugees

“…As shown in Appendix 3, other key issues and challenges include transportation, an unfamiliar healthcare system, a lack of trust in the services and a limited understanding of how the system works, healthcare coverage and cost, time pressures associated with visiting healthcare centres, a lack of social support, employment obligations, and no continuity of care. Anxiety relating to medical treatment and particular health beliefs can also become problematic (Paisi et al, 2020). Furthermore, healthcare service frameworks for "good practice" are important to improve refugee access, equity and the quality of care as well as planning and evaluating services (Feldman, 2006).…”