Improving access to dental care for adults experiencing homelessness who live outside of capital cities

Background: In Australia, homeless adults have poor oral health. Annual dental-check-ups lead to improved oral health. The barriers and enablers of dental care that influence dental visiting amongst adults experiencing homelessness in non-capital-city areas of Victoria are not well known.

Aims: To explore the factors influencing access to dental services amongst homeless adults and use the findings to design a program that facilitates access to dental care.

Methods: A focus group method explored barriers and enablers of care as perceived by homelessness-support workers. Findings were categorised using a patient-centred-access to health care framework and used to design a dental program.

Results: Barriers included; the organisation of government-funded dental services, multiple competing needs, the cost of care, the fear of being judged, anxiety and managing appointments. Enablers were; outreach-dental-services, Priority Access Cards (PACs) and co-locating health services. A two-phase dental program was designed that utilised outreach-dental-services, PACs, free oral-hygiene products, drop-in appointments and co-located health services. Outreach-dental-services should be organised in collaboration with homelessness-service providers.

Conclusion: The cost of care and organisation of government-funded dental services were barriers to care. Outreach-dental-services, allowing drop-in visits, PACs, free-care, co-located health services and better advertised dental services would enable access to care.