Community Dental Services (CDS) has been piloting a treatment programme for people with severe multiple disadvantages (SMD) and/or homelessness. The pilot is a partnership between CDS and the East Midlands Primary Care Team, working on behalf of five Integrated Care Boards in the Midlands.

The CDS Mobile Dental Clinic has been visiting locations in Nottinghamshire, Derbyshire, Leicestershire and Lincolnshire that offer established services for people who are homeless. Patients are supported to attend appointments in a familiar environment for check-ups and follow-up treatment.

People experiencing SMD and homelessness face many barriers to accessing oral health care and experience higher levels of dental caries and periodontal disease than the general population. Poor oral health is linked to a decreased quality of life among these patients, compounding issues such as poor diet and substance misuse to alleviate pain.

Thirty-six per cent of people who are homeless have accessed A&E services due to oral health-related pain. People who are homeless can often feel ashamed and embarrassed to attend a dental practice full of people, fearing that they will be judged, as well as facing difficulty finding and registering with a dentist without a fixed address.

The pilot was specifically designed around this patient group's needs, with the mobile dental clinic attending places they are already familiar with and trust.

Nicola Milner, chief operating officer for CDS in the Midlands, said, “We know people who are homeless have multiple problems with their oral health. They find it incredibly difficult to access the care they need, experiencing pain, frequently visiting A&E, or even resorting to taking out teeth themselves.

“We worked closely with people who support this group of patients, and we are becoming known and trusted. It is fantastic that we can provide a positive experience for patients who may not have had good experiences accessing dental care before and to relieve their pain and embarrassment associated with their teeth.”

So far, the mobile clinic has seen 145 patients at twice-weekly sessions, which are also an opportunity to signpost to other services, such as smoking cessation and drug and alcohol support. The mobile clinic is equipped to provide a full range of dental treatments. Feedback from patients has been overwhelmingly positive:

One patient said, “I think this service is invaluable to me. I have not been to a dentist for several years. My teeth are a state from years of drug abuse and being beaten up while living rough on the streets. The dentist was very kind and put me at ease while looking at my teeth and guided me through the process/appointments. This is the beginning of the new me. Thank you so much.”

Another patient commented, “I cannot thank the dentist enough for the support they have shown me. The dentist was non-judgemental towards me, as I was living in a tent in Derbyshire for over two years. To be honest, my teeth were the last thing on my mind, but looking back, my teeth are one of the first things other people see. I know that I would have never gone to a dentist surgery as I am far too embarrassed.”

The pilot began in June and is set to continue for 12 months.

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