Hidden Pain – How A Lack Of Dental Care Worsens Living Situations For Homelessness & Unsheltered

More Than Just A Toothache

When you think of someone experiencing homelessness or living unsheltered, the causes that first come to mind may be; unemployment, substance abuse, mental or physical illness, lack of affordable housing, domestic violence, etc. Though these issues are what can cause or lead to homelessness, the state of your body and mind becomes so damaged it is hard to escape a period of homelessness once one begins. Homelessness affects one's ability to eat, sleep, or interact with normal, everyday people. However, one issue that is underlooked in this is how poor dental health can worsen conditions of homelessness.

The Cycle Of Poor Oral Health

When we apply for a job, a loan, or even are in public settings, our physical appearance means a lot. That goes for the clothes we wear and our physical appearance. When folks are experiencing homelessness, it is very difficult to have a professional or clean appearance. A major issue has to do with the access of oral and dental health. With poor oral health, one's physical appearance may be seen in a negative way. Trying to find employment or finding housing may be difficult to accomplish with poor oral health due to potential threats of foul smelling breath, gum disease, or tooth decay.

Physical appearance matters a lot especially when applying for a job. Without a job to provide a stable income, it makes it extremely difficult to escape being homeless. To expand off of this cycle, it is not just employment that is affected but also one's personal health. Risk of tooth decay and gum disease can lead to oral infections and other diseases that are harder to cover. With a lack of adequate access to healthcare, dental and oral health infections can worsen one's overall health. 

Organizations Providing Solutions

Fortunately, some programs are working to bridge the gap:

• National Health Care for the Homeless Council – Advocates for better healthcare access for homeless individuals, including dental care.

• Mission of Mercy – Provides free dental services through mobile clinics in various U.S. states.

• Remote Area Medical (RAM) – Offers free pop-up dental clinics for those in need, including the homeless.

 

Restoring Dignity: How Dental Care Helps Homeless Veterans Build Their Healthy Life

Unforeseen Health Issues Among Veterans

When we typically think of the struggles that homeless veterans endure returning from combat, we typically think of broader issues such as mental health and unemployment. As these issues are very devastating and disastrous to both one's mental and physical well being, one specific area that is severely under
looked is their access to healthcare. More specifically, is their access to oral and dental health. 

Why Homeless Veterans Struggle With Dental Care

Dental care is not fully covered by the Department of Veterans Affairs (VA) unless a veteran is 100% disabled or was a prisoner of war. Because of these strict requirements, there are still thousands of homeless veterans who have no access to basic oral care or even tools to maintain oral hygiene. Because of this, many suffer from tooth decay, gum disease, and various oral infections. 

With poor oral hygiene from lack of access and affordability, this makes it harder to find a job. Without being able to have a stable income, it makes it even harder for veterans to be able to receive the care that they need. 

Programs Reaching Out

Despite the struggles that veterans face regarding their oral healthcare, we still see that there are other various sources and networks reaching out to help 

• The VA Homeless Veterans Dental Program provides partial care depending on the health and current diagnoses of a veteran

• Stand Down Events across the country is a group of volunteers who come together to help veterans be given food, clothing, and health screenings, as well as referrals to housing, employment, substance abuse treatment, and mental health counseling

• Nonprofit organizations like Homeless Not Toothless is a great source for homeless and unsheltered individuals to have oral care they desperately require

Why This Matters

Despite the major political divide in our country, one thing should be very clear; we need to treat our veterans when they return home. As these men and women help protect us from potential threats around the world, they deserve to be treated with the proper care they deserve upon returning home. Similar to post World War II, we should strive as a country to help our veterans return to their feet by offering more access to services including oral and dental healthcare. Dental care should not be a privilege, it should be a right to every American and especially those who have sacrificed their lives for our country. 

Resources To Reach Out 

Homeless Not Toothless 

https://www.homelessnottoothless.org/

Stand Down Events

 https://www.va.gov/homeless/events.asp

Bridging the Gap: A Former Public Health Worker on Healthcare and Homelessness

An Interview with Jean Dentinger

Access to healthcare is a fundamental right, yet for people experiencing homelessness, it remains one of the most significant challenges they face. In this interview, we sit down with Jean Dentinger, a former public health outreach professional, to discuss the real barriers unhoused individuals encounter when seeking medical care. From systemic hurdles to the personal struggles of building trust, Jean shares invaluable insights on what’s needed to bridge the gap between healthcare services and the people who need them most.

The full interview can be accessed and viewed with this link:  

https://youtu.be/Hce5Wi1ZO04

Understanding these challenges is just the first step. Providing healthcare to unhoused individuals isn't just about offering services, it’s about fostering trust, reducing stigma, and creating sustainable solutions. If you want to learn more or support organizations working on this issue, check out the resources listed at the end of this video. Together, we can advocate for a healthcare system that truly serves everyone.

Resources: 

https://www.ojp.gov/ncjrs/virtual-library/abstracts/project-respond-effective-response-homeless-mentally-ill-police-and#:~:text=Project%20Respond%20is%20a%20crisis,urban%20core%20of%20Portland%2C%20Oregon.

https://www.samhsa.gov/communities/homelessness-programs-resources/

https://www.hhs.gov/programs/social-services/homelessness/resources/

https://healthcenter.multco.us/current-patients/find-more-support/mobile-clinic

https://outsidein.org/health-services/mobile/

https://centralcityconcern.org/health-care-location/mobile-health/

Teledentistry: A Game-Changer for Accessible Dental Care

Online oral health appointments are helping to expand access to dental care for underserved groups.

Going to the dentist isn’t exactly the average person’s idea of a great time, but for many, it’s not even an option. Cost, scheduling, and a lack of access to providers can make regular checkups impossible. And without regular checkups, small issues can go unnoticed, snowballing into major life-altering (and expensive) emergencies.

But what if a dentist could come to you—at least virtually? That’s where teledentistry comes in.

What is Teledentistry?

It’s exactly what it sounds like—dentistry, but online. Using video calls, photos, and digital tools, teledentistry lets you consult with a dentist without stepping into a clinic. Long commutes? Gone. Waiting rooms? Eliminated. Pants? Unnecessary—but you better still be wearing them anyways. All you need to do to talk to a dentist is just hop on a video call, or send in photos of your teeth for review. A dentist on the other end will take a look, then give you advice on your next steps.

It’s no replacement for in-person visits, but it’s a great option for the simple things—like consultations, follow-ups, and basic screenings—the ones where you would have had to block out half a day for only a 10 minute conversation.

Who Can This Help?

The short answer? A lot of people.

• People in rural or underserved areas – Many communities don’t have easy access to a dentist, but a virtual consultation can help determine if an in-person visit is even necessary.

• Busy individuals and families – Instead of taking time off from work or school, patients can get quick guidance from a professional online.

• Houseless individuals – Housing struggles can make it difficult to find opportunities to see a dentist, even with low-cost or no-cost options available—but teledentistry allows anyone to see a dentist as long as they have a device with internet access.

• Those facing financial barriers – Teledentistry is often more affordable than a full office visit, with some services even being covered by Medicaid or low-cost programs.

What’s the Catch?

You’ll never get a filling over Zoom. Teledentistry won’t ever replace in-person visits, but it can bridge the gap for people who otherwise wouldn't see a dentist at all. And that’s a big deal.

More clinics are starting to offer virtual consultations, and as tech continues to improve, this could become a game-changer for dental care access.

Want to learn more about teledentistry? Check out the nonprofit CareQuest Institute for Oral Health and see how teledentistry stacks up against traditional care.

Need Free Dental Care? PCC’s Dental Clinic is Looking for Patients

The PCC Dental Clinic is offering free Dental Care to anyone who schedules an appointment.

Dental care is expensive—there’s no getting around that. Even a basic cleaning can cost more than you’d expect, and anything beyond that? You’d better have good insurance. Fortunately, if you’re needing a trip to the dentist (but your wallet’s got severe dentophobia), PCC runs a free dental clinic right on the Portland State campus downtown. And they’re currently looking for patients.

If you’ve been putting off a trip to the dentist because of cost, this might be exactly what you need.

What the PCC Dental Clinic Offers

The PCC Dental Clinic, located in the Vanport Building at PSU, is staffed by dental hygiene and dental assisting students. It’s a teaching clinic where students provide care under the supervision and guidance of licensed professionals, and as long as you schedule ahead, the services are available to anyone. Since it’s part of a training program though, the appointments can take longer than usual—but in exchange, you get free, high-quality dental care.

Here’s what they offer:

• Dental exams and X-rays

• Teeth cleanings (regular and deep cleanings)

• Fluoride treatments and sealants

• Basic fillings

• Oral health screenings

They don’t handle emergencies or more complex procedures like root canals, crowns, or extractions; but if you’re looking for routine care, it’s a solid option—especially considering that the only cost is your time.

Why This is Worth Your Time

Because this is a teaching clinic, there’s a time commitment. Procedures may need multiple appointments, and each of those can last up to 3.5 hours—not ideal if you’re in a hurry, but the price is unbeatable. If the time commitment isn’t a deal-breaker for you, they actually need more patients right now, meaning it’s a great time to secure an appointment. New patients are admitted by waitlist, and the clinic isn’t open during the summer—meaning you’ll want to grab a spot now before all of the Spring slots fill up.

How to Schedule an Appointment

If this sounds like something you—or someone you know—could use, getting started is easy. They don’t take walk-ins, but all you have to do to secure an appointment is reach out to one of their contact methods below.

Location: 1810 SW 5th Ave, 3rd Floor, Portland, OR 97201
Phone: 971-722-4909
Email: dentalclinic@pcc.edu

Want more info? Check out the PCC Dental Clinic Website here! 

Spots won’t stay open forever, so if you’ve been putting off that dental visit, now’s the time to take advantage of this. Call or email today to book an appointment.

Why Emergency Rooms Aren’t the Answer to America’s Dental Health Crisis

People experiencing homelessness often face significant barriers to accessing dental care which leads many to seek relief for dental pain in hospitals' emergency departments. This not only results in higher healthcare costs but also fails to provide definitive delta treatment which further perpetuates a cycle of inadequate care. Non-traumatic dental conditions account for around 1.8% of all emergency department visits in the US, which comes out to over 2 million visits a year. A large percentage of these visits are, unfortunately, people who lack regular access to dental care, especially those experiencing homelessness. The financial issues of dental-related emergency visits are also considerable. In 2017, the total cost of these visits was more than $2 billion nationwide. This highlights the inefficiency of using emergency services for dental issues, especially when these visits rust in a very brief relief. Another issue with this reliance is that emergency departments are not usually equipped to provide comprehensive dental treatments. Patients typically receive things like pain management without addressing the underlying dental problems. This leads to recurring visits for the same reasons, increasing overall healthcare costs without improving oral health outcomes. 

https://intjem.biomedcentral.com/articles/10.1186/s12245-022-00435-3

https://journalofethics.ama-assn.org/article/how-should-emergency-department-clinicians-respond-unmet-dental-needs/2022-01

To mitigate these issues we could try several things. One way could be to enhance access to preventive dental care. By expanding our community-based dental practices, we can provide preventive and restorative services to the underserved population in Portland. Another way is to integrate dental and medical services. Combining dental with primary care settings can help comprehensive care and early intervention. Emergency departments often serve as a last or only resort for dental care, but they can only provide temporary relief rather than addressing root causes. Expanding access to preventative dental care and integrating dental services into primary care can help lessen the reliance on the ER and make sure that there are lasting solutions for those experiencing homelessness.

Links to Affordable Care and More Information:

Bridges Collaborative Care Clinic:

https://www.bridgesclinic.org/faqs-1

Student-run, inter-professional free clinic offering dental services to the underserved

Coalition of Community Health Clinics:

https://coalitionclinics.org/find-a-clinic/dental-clinics

Offers a list of dental clinics in Portland providing full dental services, including exams, x-rays, extractions and fillings.

Medical Teams International:

https://www.medicalteams.org/

Provides dental care to people experiencing homelessness, known for their mobile dental bus!

 

More about Oral Health and Homeless Children:

https://headstart.gov/oral-health/brush-oral-health/caring-oral-health-children-experiencing-homelessness

More About Oral Health and Homeless Pets:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9236561/

The Mind-Body Connection You’re Ignoring: Mental and Dental Health

Dental and Mental health may seem completely different, but it turns out they have a deep connection and ignoring one could put the other at risk. Research has demonstrated that poor mental health can contribute to deteriorating oral health, while dental issues can worsen mental health conditions. Individuals experiencing depression, anxiety, or other mental health disorders often struggle with keeping up with their daily oral hygiene. Feelings of lack of motivation or heightened stress can lead to neglecting essential dental care routines, which then increases the risk of cavities, gum disease, and many other complications. And surprisingly, many psychiatric medications contribute to dry mouth, which accelerates tooth decay and oral infections. On the other hand, the consequences of poor oral health itself can be psychologically damaging. Dental pain or visible dental issues can lower people's self-esteem or exacerbate conditions like depression and anxiety.   

https://www.psychiatry.org/news-room/apa-blogs/how-dental-health-and-mental-health-are-connected

Addressing this issue requires a more integrated approach to healthcare. Dental and mental health professionals need more collaboration between each other so they can improve both treatment outcomes and preventative care. People experiencing difficulties in either area should seek professional support as intervention in one area can significantly benefit the other. 

Here are some affordable options for the Portland area:

Mental Health:

Multnomah County Behavioral Health Call Center:

503-988-4888 

Offers free behavioral health support, language interpretation, referral to low cost agencies, help finding health support, etc.  

William Temple House:

https://www.williamtemple.org/our-services/counseling/

Offers affordable counseling services to individuals, couples and families, they help clients achieve their therapeutic goals.

Portland Therapy Center:

 https://www.portlandtherapycenter.com/sliding-scale-affordable-therapy-50-and-under

Offers a directory of therapists in Portland who provide sliding scale services under $50.

Dental Health:

Portland Community College Dental Clinic:

https://www.pcc.edu/dental-clinic/

Provides free preventive and restorative dental care. Licensed professionals supervise the student clinics, ensuring high-quality services. 

OHSU Dental Clinics:

https://www.ohsu.edu/dental-clinics/costs-and-insurance

Offers comprehensive dental services at reduced rates, 30% to 40% lower than private practices, making it a viable option for uninsured patients. 

Gateway Grace Dental Clinic:

https://www.pacsonline.org/dental

This clinic also offers comprehensive dental care to adults earning up to 300% of the federal poverty line and is run by Portland Adventist Community Services.