# Dental Health Adjuncts and Care: Exploring Access Among Asylum Seekers and Refugees in London, United Kingdom

## TL;DR

This study explores dental health and access to care among asylum seekers and refugees in London, finding significant issues with toothbrushing habits, dental care access, and dental pain.

## Contribution

The study provides new insights into dental health disparities among asylum seekers and refugees in the UK, highlighting predictors of dental care access and oral health behaviors.

## Key findings

- Many PSAR do not routinely brush their teeth or access dental care.
- Female PSAR are more likely to brush their teeth and access dental care.
- Dental pain is common among PSAR, with significant predictors including age and travel mode.

## Abstract

This work examines and describes dental health among people seeking asylum and refugees (PSAR) who are evaluated by the Respond service. This includes access to and use of oral health products, access to dental care, and experience of dental pain.

The Respond service pilot offered holistic health assessments to PSAR in temporary accommodation within North Central London between July 2021 and March 2023. Relevant data were extracted from anonymized health records of individuals seen by Respond. Data were analyzed with SPSS (version 28.0.0.0; IBM) to produce descriptive statistics and regression models.

An overall 1,390 PSAR were included; 78.7% were male. The mean ages of adults and children were 31.6 and 6.8 y. Seventy-seven countries of birth were reported, most commonly Iran (23.1%). Over two-thirds (67.1%) of PSAR were not accompanied by family members; only 17.2% had UK family links. The mean travel duration was 769.3 days; migration reasons were multifactorial, including persecution (31.2%) and conflict (20.5%). In addition, 77.3% of PSAR reported having access to a toothbrush; only 50.8% indicated routinely brushing their teeth, with 38.9% having seen a dentist in <36 mo. Dental pain was common (28.8%). Only 45.8% of children (<16 y) had access to a toothbrush, 32.3% were brushing their teeth twice daily, and 9.7% cited dental pain. Logistic regression identified significant predictors of routine toothbrushing, access to dental care, and dental pain. Female PSAR were more likely to routinely brush their teeth (adjusted odds ratio [OR], 3.19; P < 0.001) and access dental care (adjusted OR, 0.57; P < 0.05). PSAR aged 30 to 39 y (adjusted OR, 1.97; P < 0.05) and those with informal travel modes (adjusted OR, 1.82; P < 0.001) were more likely to experience pain.

There is variation in the dental experience of PSAR, but a significant proportion are failing to perform routine toothbrushing, are not regularly accessing dental care, and are experiencing dental pain.

Knowledge Transfer Statement: The results of this analysis suggest that there is variation in the dental experience of people seeking asylum and refugees, but many are failing to perform routine toothbrushing, are not regularly accessing dental care, and are experiencing dental pain.