Helping the homeless: what can we do – Dr Michael Sultan

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  Posted by: Dental Design      6th April 2019

In recent years, there has been a big drive in dentistry towards helping homeless people in local communities. Not only do various charities such as Dentaid and Smile4Life strive to bring better oral care to this demographic, but there has been an increase in practices offering accessible dental treatment – and this is something that all of us as dental professionals should really consider.

When evaluating one sample group of 728 homeless people, Smile4Life found that 98% of them had dental decay and that over half of them had extracted or missing teeth.[i]These figures just go to show how serious the problem of oral health complications is amongst homeless people, and how many of them are suffering due to not having access to dental treatment.

Of course, when we think of providing treatment for the homeless it’s often about helping these people overcome oral pain. Understandably, homeless individuals are more prone to dental health problems. Not only do they not have easy access to essentials such as clean running water, toothpaste, toothbrushes and floss, but by living on the streets, they have a higher risk of being impacted by substances such as drugs and alcohol[ii]– both of which can negatively affect oral health in a number of ways. Together these factors go some way towards explaining why bad oral health is such a pandemic amongst this group of people, and why it’s so important that we, as dental professionals, reach out and help.

Indeed, it’s important to remember that substance abuse and homelessness often have a two-way relationship, and one may easily lead to the other, forming a vicious cycle that is difficult for these individuals to escape. Alcohol has been proven to alter the bacteria in the oral cavity, leading to an increased chance of gum disease and other problems.[iii]Many narcotics commonly used by those living rough such as crystal meth and cocaine can both harm teeth due to their acidic nature. They may also encourage enhanced decay as they cause dry mouth and users to crave sweet treats.[iv]These drugs may also trigger people to grind their teeth as they experience a high, wearing down the enamel or chipping or loosening the teeth which can quickly lead to tenderness and further oral problems.

Figures from homeless charity Crisis reveal that in 2017, as many as 4,751 people were sleeping outside every night in the country – a figure which excludes any homeless people who can find nightly shelter. In fact, the charity also suggested that as many as 57,890 households were accepted as homeless in 2017 – indicating how widespread the problem actually is. What we often forget is that homelessness doesn’t just mean people living on the streets, and there may be individuals who rely on squatting at B&Bs or sleeping on sofas, and these people cannot be excluded from the total number of people who are considered homeless within the UK.

So what can we do to help these people? It really is as simple as following the example set by others in the industry. Perhaps you could open your practice for a day and provide treatment free of charge for these people, or maybe you and your staff can band together and do a fundraiser to earn some money to donate to charity. Treatment, in particular, can make a huge difference to these individuals, as many of them could be suffering from problems such as chronic pain caused by decay, and can only turn towards drink and narcotics to numb the problem.

Furthermore, we cannot discount the effect that treatment may have on the road towards rehabilitating these people. A good smile is worth a thousand words, and by supplying these people with life-changing treatment such as dentures, we can inspire them to help get their self confidence back by restoring their smile aesthetics – something which society places so much value on today. In fact, research has found that offering lasting solutions for homeless people and helping them to maintain good oral health is actually an important step towards helping them regain a foot in society.[v]This is likely because of the increased sense of self-esteem good dental treatment can provide.

Overall, it’s important that we as professionals extend our care as far as possible. Homeless people may not have the opportunity for dental treatment very often in their lives, so by choosing to help, even for one day, you can make a huge difference – proving that dentistry is, at the root of it, still first and foremost about care.


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[i]Smile4Life. The Oral Health of Homeless People Across Scotland. Link:[Last accessed November 18].

[ii]Crisis. Drugs and Alcohol. Link: [Last accessed November 18].

[iii]Medical News Today. Alcohol Promotes Disease By Altering Oral Bacteria. Link:[Last accessed November 18].

[iv]American Addiction Centers. How Does Drug Abuse Affect Teeth Health? Link:[Last accessed November 18].

[v]Homeless Link. Empowering People to Bring Back Their Smile. Link:[Last accessed November 18].

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