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Management of plaque in people experiencing homelessness using 'peer education': a pilot study


Introduction People who experience homelessness have poor oral health and limited access to dental services.

Aim To examine whether 'peer education' could yield improved plaque management among people experiencing homelessness.

Methods A quasi-experimental, one-group pre-test-post-test study was conducted, with follow-up at one and two months. Participants were living in temporary accommodation in Plymouth, UK. Plaque levels were assessed using the simplified oral hygiene index. A questionnaire and the oral health impact profile (OHIP-14) were administered. Patient satisfaction and barriers to dental care were explored by interviews.

Results The baseline sample included 24 people with a mean age of 36.88 ± 10.26 years. The mean OHIP-14 score was 25.08 ± 19.56; finding it uncomfortable to eat and being embarrassed attracted the highest values (2.46 ± 1.53 and 2.33 ± 1.63, respectively). Plaque levels decreased by month one and month two, though the changes were not statistically significant. Positive changes in confidence in toothbrushing at month two were identified (p = 0.01).

Conclusion Experiencing pain and the opportunity to access treatment were key drivers of study participation. The study indicated that it is feasible to conduct oral health promotion projects for people in temporary accommodation. Adequately powered studies examining the impact of peer education on improving homeless people's oral health are warranted.

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The authors are extremely thankful to the Oral and Dental Research Trust (GSK Research Award) for providing funding for this study. We also thank the charity Well Connected for providing the goody bags distributed at baseline, and PDSE for providing us with clinical equipment and consumables. Many thanks to Stephan Morrison from Groundswell for leading the focus groups. A very big thank you is due to the dental team and administration staff at PDSE, particularly Christina Worle, for providing care to our participants free of charge. The study would not have been possible without the support of the lead volunteer and our participants.

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Correspondence to Martha Paisi.

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The authors declare no conflicts of interest. The funders had no role in the analysis or interpretation of data.

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Paisi, M., Witton, R., Burrows, M. et al. Management of plaque in people experiencing homelessness using 'peer education': a pilot study. Br Dent J 226, 860–866 (2019).

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