BDJ

Top Tips for Managing People who Experience Homelessness & Social Exclusion in Primary Care

I am super proud of one of my latest articles to be published in the British Dental Journal, with top tips for dental teams who work in primary care when caring for people who experience homelessness and social exclusion...



While there are some patients who experience homelessness who need intervention and care from community dental teams or special care dentistry in hospital settings, the vast majority of this group can be treated in primary dental care settings by general dental practitioners. 

There are challenges when caring for this group, for example:
  • High fail to attend rates and difficulty in engaging patients. This is multi factorial (for example, it might be difficult to communicate appointments with them, they might have varying priorities which trump attending a dental appointment, they might struggle to travel to a dental practice etc), but can be very challenging particularly in UDA based setting 
  • Complex mental health and medical needs which affect dental treatment - such as bleeding issues from chronic alcohol use, unpredictable behaviour, consent concerns
Moreover, the oral health of this group is poor and many have chronic dental issues such as pain and poor self-esteem due to their smiles. 

My top tips in this article cover:
  1. How to clarify payments and exemption from dental charges - for example, completion of HC1 forms
  2. How to obtain reliable contact details to communicate appointments and follow-ups - often using an advocate who is able to support the patient with their health needs
  3. How to combat missed appointments and reduce failed appointments 
  4. Strategies to manage patients complex needs including their medical issues, mental health problems and addictions
  5. How to tailor prevention advice so it is meaningful and attainable for this patient group
  6. How to treatment plan these patients
  7. What is trauma-informed care and resources to train the entire dental team
  8. How to improve access the NHS dental care for this group
To read the article in full, please click here


If you have any questions about the article or how to care for these patients in your service, please leave comments below.

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