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Shining a light on Oral Health: Overcoming Social Exclusion for the Homeless Community

Updated: Oct 27, 2023

One of the most asked questions the HART team is asked:

“Can you find me a dentist?”

Any form of poor oral hygiene can cause discomfort, be extremely painful and have a major impact on our daily lives consequently, poor access to dental services is having a significant impact on homeless and vulnerable people’s lives.

A recent study by Groundswell revealed the extent of oral health problems homeless people are facing, problems with teeth, gums and mouths were widespread and dramatically higher in the homeless, than the general population. This problem is not just in the Rochdale Borough but UK-wide, and it is so frustrating not only to the people who need the dentist but also to professionals who are trying to improve the health and well-being of this cohort of people.

Further findings revealed the extent of health inequality experienced by homeless people (Groundswell 2017):

  • 90% of people have had issues with their mouth health since becoming homeless.

  • 30% of homeless people currently experience dental pain.

  • 15% of homeless people have pulled out their own teeth.

  • 27% of participants have used alcohol to help them deal with dental pain and 28% have used drugs.

  • Loss of teeth becomes a factor.

  • 27% have attended A&E when they have dental problems

Keeping our mouths and teeth healthy enables us to chew food, speak clearly, shape our faces and allow people to smile with confidence and self-esteem. Unfortunately, due to being homeless and experiencing social exclusion, people are finding it difficult to access treatment. This type of lifestyle and low levels of self-care, smoking, drinking alcohol, drug use, and eating and drinking sugary foods to get through the day all add to tooth decay, and the overall effect on maintaining a healthy mouth.

When Mental health is poor, or we find ourselves in a situation where we are homeless, have no money, and family and friends are in the past, it all influences our health and well-being. Caring for our teeth and mouth can be the last thing we think about.

I recently visited a man who was being supported in a hostel, he had mental health issues and was prone to self-neglect. All the time he was talking to me, he covered his mouth up and spoke through his hand, he never once smiled. After a few visits, I felt he had gained some trust in me, so I asked, “When was the last time you brushed your teeth?” the reply was 16 years ago! Cleaning a plaque-ridden tooth is difficult. If you don't brush your teeth for a week, you're more likely to develop cavities. There's also a chance that the plaque will begin to irritate your gums, causing them to hurt even more. Fortunately, he had no pain at this time. He agreed to me obtaining a toothbrush and a mild toothpaste, which is still sitting in his bathroom!

Each time his support worker as a one-to-one, he mentions his oral care, he just needs time. Hopefully by building trust and knowing people care for him, the day he brushes his teeth will come.

Finding an NHS dentist to register with is extremely hard, however, if the person is in pain, you can ring 111, and they will search for a dentist in your area and get you an appointment as soon as possible to help solve the problem. If you are on benefits or an asylum seeker the NHS dentistry is free.


  • Brush your teeth twice a day

  • Brushing teeth last thing at night is extremely important

  • Try not to rinse your mouth afterwards

  • Floss your teeth daily

  • Visit your dentist regularly to check both your teeth and mouth are healthy. Even if you have no teeth.

  • Cut down on sugary food and drinks.

DRUGS, SMOKING and ALCOHOL all have an impact on your mouth.

CANNABIS – increases the risk of decay and gum disease.

CRACK - causes oral sores increasing the risk of blood-borne infections.

COCAINE – can lead to damage to the roof of your mouth and when you rub into your gums this causes decay.

HEROIN – causes inflammation of the gums and teeth loss.

METHADONE– contains a lot of sugar increasing the risk of tooth decay. Ask for sugar-free at your Pharmacy. Always brush your teeth before and after taking the methadone.

It's never too late to make your oral health a priority again, no matter how long you've been without dental care.



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