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

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.

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. 

Preventative Approaches to Dental Care Before an Emergency Room Visit

        

        To many people, toothaches may seem like a minor inconvenience and could be a quick fix at the dental office. Still, to others who experience homelessness and are unable to receive the services to prevent them, toothaches can be a reason to visit an emergency room, as they are unable to make that easy and accessible trip to the dentist. Those who are homeless or who do not have health insurance are often left to endure the oral pains and ignore those issues until the matter worsens and calls for an emergency room visit. 

        Visits to emergency rooms are only temporary solutions to the growing problems of oral pains due to poor dental care. This can become a cycle for the homeless community in which they find themselves repeatedly visiting emergency rooms to treat all oral health issues. Through preventative measures, the homeless community would have the opportunity to treat any dental health issues promptly, rather than letting the oral matter worsen through time. 

        Rafael Figueiredo et al.. conducted a study on using the emergency department due to oral issues. The study examined 1,189 people who were homeless and studied how often they visited the emergency department for dental issues. The results found:

        80% of homeless individuals had visited the emergency room because of odontogenic infections,                while 46% of those individuals had made that visit more than once. This study was conducted from            2005-2009 in the Ontario, Canada area. 

        

        This is just one example of visits that are seen within communities of people who are homeless visiting the emergency department. The study could be used as an example for different regions as these visits by people who are homeless could be seen as a widespread and systemic issue, where the lack of preventative measures has caused this issue. Other reliefs that can be substituted for emergency room visits could be an investment in preventative dental care, which could reduce the number of visits individuals make for something that can be prevented. 

Some accessible and affordable dental care options for individuals who are homeless could be:

        Mobile Dental Clinics:

• https://www.medicalteams.org/emergency-dental-clinics/
• https://healthcenter.multco.us/current-patients/find-more-support/mobile-clinic#657-what-is-a-mobile-clinic

        Community Dental Programs: 

• https://www.bridgesclinic.org/faqs-1
• https://www.greaterportlandhealth.org/services/dental

        Through advocacy and accessible information regarding this matter, more people will be able to access the care they need. As a community, we need to focus on the fundamental importance of dental care for people who have minimal to no access to it. Spreading awareness and knowledge can help others in need of these services. 

Sources: 

Figueiredo, R., Dempster, L., Quiñonez, C., & Hwang, S. W. (2016). Emergency department use for dental problems among homeless individuals: A population-based Cohort Study. Journal of health care for the poor and underserved. https://pmc.ncbi.nlm.nih.gov/articles/PMC4889437/

        

Ensuring Access to Dental Care for Homeless Individuals in Oregon

Access to dental care is essential for overall health, but many homeless individuals face challenges in receiving the treatment they require. Fortunately, Oregon offers various free or low-cost dental services options through the Oregon Health Plan (OHP), Federally Qualified Health Centers (FQHCs), and community clinics. Here’s how homeless individuals can obtain the dental care they need and how others can help facilitate access. Federally Qualified Health Centers (FQHCs) and community clinics. Here’s how homeless individuals can get the dental care they need and how others can help facilitate access.

Federally Qualified Health Centers (FQHCs) & Free Clinics

FFQHCs and free clinics are crucial in providing dental care to underserved populations. These organizations offer care on a sliding scale* based on income, ensuring affordability for all patients, including those without insurance.

* A sliding scale adjusts fees based on income, making services more affordable for low-income and homeless individuals who may have limited financial resources.

FQHCs in Oregon:

• Central City Concern (Portland) – Offers medical and dental services to homeless individuals.
• Learn More: https://centralcityconcern.org/
• Outside In (Portland) – Specializes in care for homeless youth and adults.
• Learn More: https://outsidein.org/

Oregon Health Plan (OHP) for Dental Care

OHP is Oregon’s Medicaid program that provides free healthcare, including dental services, to eligible low-income and homeless residents.

Eligibility for OHP:

Based on factors such as income level, Oregon residency, and other considerations, individuals can apply for services or assistance. Homeless individuals are eligible to apply even without a permanent address, ensuring that those facing homelessness can still access support.

How to Apply for OHP:

• Online: https://www.oregon.gov/oha/hsd/ohp/pages/index.aspx
• Phone: Call 800-699-9075 for assistance.

Ensuring that homeless individuals have access to dental care is a crucial step in improving their overall health and quality of life. Affordable and accessible dental care is available through OHP, FQHCs, and community clinics, but spreading awareness and assisting with the application process can make all the difference. Whether by helping someone enroll in OHP, directing them to a free clinic, or providing transportation support, every small effort helps bridge the gap in healthcare access for those in need.