Homelessness and dental care in unique research

“Homeless people associate oral health with feelings of human dignity,” says Patricia De Palma, dentist and author of a new doctoral thesis on homelessness and dental health. “If dental care is made more accessible, it could be an important link between homelessness and a tolerable life.”

The formal account of the dental health of the homeless – the first ever – makes depressing reading. The 147 homeless people included in the study had an average of 18 teeth each, eight less than the average Swede. Seventy per cent of the homeless had no toothbrush, and their remaining teeth were often in such a poor state that they had to be removed. Many found it difficult to chew and ingest food.

Using in-depth interviews, Patricia De Palma has also examined homeless people’s thoughts about dental care and dental health. The interviews, which were conducted both before and after dental treatment, show that dental care can achieve much more than healthy teeth.

“Many of those who’d lost teeth talked about a changed personal image,” she says. “They felt stared-at, amputated. After treatment, however, they felt that they had grown as people and become a little more normal.”

Despite the universal right to state-subsidised dental care, homeless people are effectively denied access to it, according to Patricia De Palma.

“We have the world’s best dental care in Sweden, but only for those who can pay,” she says. “This is unacceptable. The national health insurance and national dental insurance must be coordinated to make sure no one falls through the net.”

Since 2002, Patricia De Palma has been running a dental surgery in Stockholm for homeless people.

Thesis: Oral health among a group of homeless individuals from the dental professional’s and patient’s perspective