Oral health is a critical component to the overall health and wellbeing for a child. Oral health is influenced by a variety of factors including socio-economic status. Residential instability, namely parental divorce, can significantly impact on access to dental care. Parental status information is not often captured by standard socio-economic determinants and often not screened for in the social history.

There has been a rise in joint legal custody arrangements in recent decades due to a shift towards more egalitarian gender roles.1 As a result there has been increased interest in how children fare in different post-divorce child residence arrangements.1 There is little evidence detailing how stable residence arrangements are in the long run and whether instability poses a risk to a child's overall well-being.1

Instability in housing arrangement can cause access to care issues. Barriers to accessing care leads to untreated dental disease. Untreated dental disease has consequences including pain, sepsis, sleepless nights, missed days at school and disruption to quality of life.2 The burden of untreated dental disease can prevail into adulthood. In addition to unmet physical dental needs, there are psychological needs that this population face. Dental fear, anxiety and phobia are a complex triad often experienced among patients with residential instability.3,4 Dental anxiety can have profound social and psychological effects that can persist into adulthood.5 It can create avoidance-type behaviour and symptom-driven treatment that can escalate over time. Paediatric dentists have a role and responsibility to alleviate anxiety. They work hard to build a rapport among anxious patients through continuous regular care and thus avoiding the creation of a dentally anxious adult. Despite this, with an unestablished dental home due to residential stability there runs a risk of diminishing the work of the paediatric dentist.

To conclude, residential stability can have an impact on a child's oral health due to access to care challenges. It is essential that clinicians do not overlook the importance of obtaining a thorough social history. Early recognition of instability can allow a clinician to provide an individualised care plan for a child so that they receive the care that they deserve.