Identifying barriers to oral health care access for unhoused individuals

This study aimed to assess causes of disparities in oral health care access and outcomes for Philadelphians experiencing homelessness, poverty, and other social risk factors through the lens of the social determinants of health. We conducted a cross-sectional study (n = 232) at 11 partner meal distribution and shelter sites from October 2023 to March 2024. Interviews assessing dental history, care access, insurance, transportation, housing, and demographics were conducted. Descriptive statistics and relationships between six predictors and 22 outcome variables were analyzed. Significant gaps in care access are present, with 90.1% lacking adequate dental insurance. Shortcomings exist in access to extractions, filling cavities (47.4%), veneers and implants (33.6%), braces/retainers (33.6%), and 33.2% lack any care access. Insurance and transportation barriers predict poor health outcomes. Social risk factors including housing insecurity, transportation, and insurance coverage shortcomings predict dental care access gaps. These barriers lead to unaddressed oral health conditions and increased care costs.