Delivering oral healthcare to asylum seekers and refugees: A mixed-methods service evaluation of charitable mobile dental clinics in England

BackgroundAsylum seekers and refugees (ASR) experience disproportionately poor oral health due to socioeconomic disadvantage and barriers to accessing routine dental care. Although ASR are entitled to free dental treatment through HC2 exemption, practical challenges persist. Charitable organisations such as Dentaid provide mobile community clinics to address this gap.AimThis retrospective mixed-methods service evaluation assessed the accessibility, utilisation, and impact of Dentaid's dental clinics for ASR in England.MethodsQuantitative data from 88 clinics delivered across 11 locations between April 2023 and August 2024 were analysed. Variables included demographics, presenting complaint, treatment provided, and smoking status. A dental-charted subsample of 50 adults was compared with national data. Fisher's Exact Test explored differences between clinic sites. A SWOT-based stakeholder survey was performed and analysed thematically to identify barriers and facilitators in service delivery.ResultsA total of 647 patients received care, with 70% presenting in pain and 42% reporting smoking, almost double the national average. The subsample demonstrated high levels of untreated decay and previous extractions. Common treatments included restorations, extractions, and preventive care. Fisher's Exact Test reported no significant differences between sites. Stakeholders highlighted improved accessibility, cultural sensitivity, and reduced financial barriers, but reported challenges with consistent funding for follow-up clinics and interpreter provision.ConclusionsDentaid's clinics improved access to urgent and preventive care for ASR who struggle to use mainstream dental services. However, reliance on charitable provision reflects structural inequity. Integration with commissioned NHS pathways and sustained Inclusion Health support are required to ensure equitable, long-term access.