Does a facilitated pathway improve access to dental services for homeless and disadvantaged adults?

Stormon, Nicole; Pradhan, Archana; McAuliffe, AJ; Ford, Pauline

doi:10.1016/j.evalprogplan.2018.08.002

Cited by 13 publications

(24 citation statements)

References 22 publications

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“…The SB Minas was an epidemiological survey of oral health carried out in Minas Gerais state from April to December 2012 that investigated the main oral health diseases at the ages of 5 Minas Gerais is the second most populous state in Brazil, the 3 rd wealthier state by the Gross Domestic Product (GDP) index, encompassing 853 cities, and it ranks 9 th out of the 27 states in Brazil on the Human Development Index and 8 th in the population over 16 years old in active formal employment. 28 The methodology of the 2010 national survey was used as reference for the collected indices: age, draw of the municipalities, census tracts, and households and individual data.…”

Section: Methodsmentioning

confidence: 99%

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Factors associated with toothache among Brazilian adults: a multilevel analysis

et al. 2020

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The aim of this study was to evaluate the factors associated with toothache in the adult population of Minas Gerais, Brazil. Individual data from a population sample (age 35 to 44 years) were collected from a secondary database of the SB Minas survey. Sampling was carried out by clusters and with multiple drawing stages. The eligibility criteria were to reside in areas chosen for the research, be within the age group, and accept to participate in the research. The individual variables assessed by a questionnaire and dental exams were sex, income, race/skin color, root caries, periodontal condition, need for dental treatment, and last dental appointment. The contextual variables, assessed by municipal indexes, were Human Development Index (HDI), illiteracy, unemployment, half minimum wage, quarter minimum wage, oral health team coverage, access to individual health care, and supervised tooth brushing average. The dependent variable was toothache in the past six months. A descriptive analysis was made using the Statistical Package for the Social Sciences and Hierarchical Linear and Nonlinear Modeling Software was used to perform the multilevel analyses for individual and contextual levels. An association was found between toothache and low income (OR = 2.00; 95%CI = 1.32-3.13), dental caries (OR = 1.86; 95%CI = 1.22-2.86), periodontal condition, and living on a quarter of the minimum wage or less (OR = 1.03; 95%CI = 1.00-1.08). Clinical and social factors were associated with toothache, reinforcing the need to improve public polices in oral health focused on the adult population.

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Section: Methodsmentioning

confidence: 99%

“…3,4 Additionally, toothache may prevent people from seeking proper dental care due to fear of pain. 5,6 Epidemiological surveys show that toothache impacts people's quality of life. 7 Toothache has been associated with high morbidity, psychological issues, and sleep impairment.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with toothache among Brazilian adults: a multilevel analysis

et al. 2020

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“…23 Homeless persons may have low rates of dental service use because of perceived stigma from dentists due to their homeless status, fear of dental treatment, cost of dental treatment, lack of information about providers, and competing priorities to meet health care and subsistence needs. [24][25][26] Dental service use was associated with primary care visits and outpatient mental health care. This suggests active oral health promotion by persons in primary care settings.…”

Section: Discussionmentioning

confidence: 99%

Association between primary heath care and dental service use among supportive housing tenants with behavioral health conditions

Hall¹,

Dai

Lim

2020

Comm Dent Oral Epid

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Objective: Homeless persons are at high risk for poor oral health. Supportive housing can improve housing stability for persons with behavioural health conditions, but its impact on dental service use has been little studied. Methods: Data for this evaluation come from matched public service records for eligible applicants to a New York City supportive housing program (NY III) targeting chronic homelessness. NY III tenants (N = 5678) were compared with applicants not placed in housing (N = 6536) and applicants placed in other supportive housing programmes (N = 4823). Regression analysis was used to assess the association between supportive housing, primary care use, clinical severity and the likelihood of dental visits. Results: Over four observation years, 71% of applicants had at least one dental visit for any cause and 57% for preventive dental care. Incidence of dental visits was lower for persons with physical disability (IRR = 0.91; 95% CI = 0.85, 0.97, P = .003), psychiatric hospital stays (IRR = 0.78; 95% CI = 0.68, 0.88, P < .001) and age over 54.

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“…Despite majority of the homeless population being eligible for public dental care, this population have increased difficulties in accessing appointments due to their lower health literacy, transient and changing lifestyles, poor understanding of the system and long waiting lists (Ford et al., 2014; Stormon et al., 2018). Therefore, the high cost of private dental care may be perceived as a barrier, with approximately two thirds of the homeless population compared to one third of the general population, citing this reason for avoiding or delaying dental care (Ford et al., 2014; Slade et al., 2004; Stormon et al., 2018). Studies have shown that cost is also associated with poorer oral health status and dental appointment attendance in Australia (Jamieson, Mejía, Slade, & Roberts‐Thomson, 2010; Slade et al., 2004).…”

Section: Discussionmentioning

confidence: 99%

“…The Australian Health Ministers’ Advisory Council identified people who are socially disadvantaged or with low incomes (which includes people experiencing homelessness) as a priority population (Australian Health Ministers’ Advisory Council, 2015). Other competing priorities, such as obtaining basic necessities such as food and housing, result in dental health being deprioritised for people experiencing homelessness (Ford, Cramb, & Farah, 2014; Stormon, Pradhan, McAuliffe, & Ford, 2018). Substance misuse is common among people experiencing homelessness and contributed to poorer mental health, nutrition, oral health and subsequently poorer quality of life in this population (Ford et al., 2014).…”

Section: Introductionmentioning

confidence: 99%

The extent and nature of dental anxiety in Australians experiencing homelessness

Yokota

Tan

et al. 2020

Health Soc Care Community

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High dental anxiety is a major barrier to accessing dental care and has been found to be experienced to a greater extent in the homeless population. No studies have investigated the extent and nature of dental anxiety in Australians experiencing homelessness and was the aim of this study. Participants were recruited from four not-for-profit organisations in inner Brisbane using convenience and snowball sampling. The Dental Anxiety Questionnaire (DAQ) and the Index of Dental Anxiety and Fear (IDAF-4C +) questionnaire and oral health screening were completed by people experiencing homelessness in Brisbane, Australia, and compared to population norms. Descriptive statistics were calculated, and non-overlapping confidence intervals considered significantly different. The majority of the participants (n = 66) were male, a current smoker, unemployed and living in government supported housing. Most of the participants rated their oral health as poor/fair (n = 46, 71.9%) and their oral function as good or higher (n = 34, 53.1%). Using the single-item DAQ, 28.2% (n = 19) of people experiencing homelessness had high dental anxiety, compared to 16% of the general Australian population. The mean summed IDAF-4C + fear module score was 18.02 (CI 15.60-20.43), which was significantly higher than the Australian population (µ = 14.40, CI 13.93-14.86). The highest mean score in the IDAF-4C + stimulus module was feeling embarrassed or ashamed as anxiety inducing (µ = 2.27, CI 1.89-2.64) and was significantly different from the general Australian population (µ = 1.40, CI 1.33-1.47). The poorer overall self-rated oral health by the homeless population may induce feelings of embarrassment or shame, highlighting the differing psychosocial aspect to dental anxiety experienced by this population. Managing dental anxiety is needed to improve accessing to dental care for this population. Multidisciplinary care from social workers, mental health workers and dental practitioners may be beneficial in managing fear. K E Y W O R D S dental anxiety, dental fear, dental phobia, homeless persons, vulnerable populations | 2353 YOKOTA eT Al.

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Does a facilitated pathway improve access to dental services for homeless and disadvantaged adults?

Cited by 13 publications

References 22 publications

Factors associated with toothache among Brazilian adults: a multilevel analysis

Factors associated with toothache among Brazilian adults: a multilevel analysis

Association between primary heath care and dental service use among supportive housing tenants with behavioral health conditions

The extent and nature of dental anxiety in Australians experiencing homelessness

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