Homelessness and Dental Hygiene

March 20^th is Oral Health Day! Oral health is a key part of our overall health and well-being but, for people experiencing homelessness, it is often one of the most difficult needs to address. When someone is focused on finding a safe place to sleep, how to stay warm, how to access to basic services, or figure out where their next meal is coming from dental care can quickly become a lower priority.

Barriers such as the cost of dental services, lack of insurance, limited access to hygiene products, and difficulty reaching clinics mean that many people living without stable housing go long periods without proper oral care. Over time, untreated dental issues can lead to serious health problems, infections, and chronic pain that significantly affect a person’s quality of life.

On World Oral Health Day, we’re recognizing how access to dental care is not equal for everyone. Raising awareness about the connection between oral health and homelessness helps highlight the need for more accessible services and support for people facing these challenges.

Cavities, gum disease, and untreated infections can lead to broken or missing teeth and ongoing pain, and, unfortunately, these are common problems for those experiencing homeless where access to preventative dental care is limited. Factors such as malnutrition, tobacco use, trauma, and substance use can also contribute to these issues and make interventions less effective.

Dental care in Canada can be expensive and difficult to access, especially for people without stable income or employment. Most dental coverage is employer-based, while government-subsidized plans typically only cover a portion of the cost and often require co-payments. Although programs like the Canadian Dental Care Plan (CDCP) exist (and are important!!), there are still eligibility requirements to qualify. For example, applicants must have a valid ID and must have filed their taxes in the previous year. These requirements can create additional barriers, making it even harder for vulnerable populations to access the dental care they need.

Additionally, there are programs throughout Alberta that allow low income individuals to get dental care like the Alberta Adult Health Benefit, Interim Federal Health Program, Radius Community Health & Healing, Public Health Dental Clinics, The Alex Dental Health Bus, and as previously mentioned AISH. However, most of these programs are offered at reduced rates and have other eligibility requirements that most homeless individuals do not meet.

Beyond the physical effects, dental health can also impact a person’s confidence and mental well-being. Missing or damaged teeth can make people feel self-conscious and can affect everyday activities like eating, speaking, or building relationships – not to mention interviewing for a new job. These challenges can become yet another barrier when someone is trying to rebuild stability in their life.

We have seen this firsthand with many of our clients; recently we had been trying to help a patient with income support applications, but she didn’t yet have a valid ID. The client shared that she didn’t want to get her ID because she was unhappy with how her teeth looked. She told us that once she was able to get her teeth fixed, she wanted to take a photo for an ID that she felt proud of. This might seem like a silly thing to be worried about when you are facing so many other challenges but it was a real problem to her that affected how she carried herself.

Two of our caseworkers also shared stories about helping clients receive dentures. In both cases, the clients needed them because their teeth were in very poor condition. Years spent living on the street had taken a serious toll, leading to severe decay, broken and cracked teeth, and damaged roots.

Our caseworkers connected with the clients and encouraged and facilitated access to dental care. Some clients don’t know they can access dental care or how to access it, while others might be intimidated out of attending medical appointments and need further support to build the confidence to show up. Our caseworkers followed up with the clients to make sure they made it to their appointments on time and attended with them in some cases. With the help of our caseworkers and an Alberta government program, both clients were able to get dentures.

For people experiencing homelessness, brushing and flossing often isn’t a priority – surviving comes first. Finding a safe place to sleep, securing food, and managing day-to-day challenges take precedence. Also the longer a person experiences homelessness, the higher their risk of developing periodontal disease. Many don’t have access to basic items like toothpaste, a toothbrush, or even clean water to brush their teeth daily. That’s why oral health is so important, yet it’s often overlooked and not given the attention it deserves.