Dental Attendance in Undocumented Immigrants before and after the Implementation of a Personal Assistance Program: A Cross-Sectional Observational Study.

Martijn Lambert

doi:10.3390/dj6040073

Abstract

Undocumented immigrants are a high-risk social group with low access to care. The present study aims to increase awareness and dental attendance in this subgroup, assisted by community health workers (CHW). Starting from 2015, two trained dentists volunteered to perform free oral health examinations and further dental care referral in a welfare organisation in Ghent, Belgium. In 2016 and 2017, a two-day oral health training was added, enabling social workers to operate as community oral health workers and to provide personal oral health advice and assistance. Over the three years, an oral health examination was performed on 204 clients from 1 to 69 years old, with a mean age of 36.7 (SD = 15.9), showing high levels of untreated caries (71.6%; n = 146) and a Dutch Periodontal Screening Index (DPSI) score of 3 or 4 in 62.2% of the sample (n = 97). Regarding dental attendance, the total number of missed appointments decreased significantly, with 40.9% in 2015, 11.9% in 2016 and 8.0% in 2017 (p < 0.001). Undocumented immigrants can be integrated into professional oral health care. Personal assistance by community health workers might be an effective method, although this requires further investigation.

Highlights

Undocumented immigrants are a very vulnerable social subgroup, consisting of a considerable number of people trying to remain undiscovered by local authorities
In contrast to asylum seekers and recognised refugees, they do not have a residence permit to stay legally in the country. Their estimated number varies between 7% and 13% of the total number of immigrants with an official residence permit [1]
In Belgium, there were 1,214,605 legal immigrants on the 1 January 2014, which means that the number of undocumented immigrants probably lies between 85,000 and 160,000, corresponding to approximately 1% of the total Belgian population [2]

Summary

Introduction

Undocumented immigrants are a very vulnerable social subgroup, consisting of a considerable number of people trying to remain undiscovered by local authorities. In contrast to asylum seekers and recognised refugees, they do not have a residence permit to stay legally in the country Their estimated number varies between 7% and 13% of the total number of immigrants with an official residence permit [1]. Epidemiological data on the oral health of undocumented immigrants are scarce, some authors previously described the oral health and oral health needs of refugees in general [3,4,5]. According to these publications, oral diseases are highly prevalent in refugees and care provision is impeded by several barriers. According to the United Nations International Bill of Human

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Conclusion