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Healthy Mouths: A peer-led health audit on the oral health of people experiencing homelessness

Author: Groundswell

Groundswell’s study – Healthy Mouths – reveals the extent of oral health problems homeless people are facing. Poor access to dental services is having a significant impact on homeless people’s lives.

  • Many participants are experiencing considerable pain on a daily basis.
  • Problems reported with teeth, mouth and gums were widespread and dramatically higher than in the general population.
  • Participants struggled to get access to the dental care they desperately need – and this is having an impact on their quality of life and wider support services.
  • Groundswell calls on health commissioners to ensure that oral health promotion and treatment is available to all people experiencing homelessness.


Groundswell engaged over 260 people currently experiencing homelessness through focus groups and one-to-one survey based interviews – exploring oral health, lifestyle factors and access to dental services. The project, funded by Trust for London, has revealed the shocking extent of health inequality experienced by homeless people. Findings include:

  • 90% of participants had an issue with their mouth health since becoming homeless.
  • 30% of homeless people are currently experiencing dental pain.
  • 7 in 10 reported lost teeth since becoming homeless. 15% of homeless people have pulled out their own teeth.
  • Alcohol and drugs commonly used in an attempt to manage oral health issues. 27% of participants have used alcohol to help them deal with dental pain and 28% have used drugs.
  • The knock-on effect is that other support services may be under increased pressure. 27% had been to A&E when they have had dental problems and it is likely that it may be putting increased pressure on mental health services.

Difficulties accessing treatment, lifestyle and low levels of self care were a key barrier to maintaining a healthy mouth:

  • Only 23% had been to the dentist in the last six months.
  • 58% were not clear on their rights to NHS dentistry.
  • Mental ill-health and substance misuse issues had an impact on self care and ability to make use of dental services.
  • Despite the many difficulties, participants clearly valued good oral health and believed dentists were there to help.

The scale of the problem and the support needs of people experiencing homelessness mean that new approaches are needed to tackle this issue.

Groundswell have produced an Action Guide that offers steps to help improve oral health and make the most of trips to the dentist. This self-help guide offers practical advice based on our findings from the research. It includes a poster that can be put on the wall of homelessness services. The guide is designed to be printed on an A3 printer and folded down to A6 paper size.

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12 May 2017

Healthy Mouths: A peer-led health audit on the oral health of people experiencing homelessness