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Factors affecting oral health care for asylum seekers and refugees in England: a qualitative study of key stakeholders' perspectives and experiences

British Dental Journal (2022)Cite this article

Abstract

Aims To investigate factors influencing oral health behaviours and access to dental services for asylum seekers and refugees (ASRs).

Methods A qualitative research study using purposeful sampling was undertaken in South West England. Online semi-structured interviews with stakeholders working with or supporting ASRs were analysed through reflexive thematic analysis.

Results Twelve participants providing support to ASRs in various capacities participated. Two interviewees had lived experience of forced displacement and the UK asylum process. Key themes into what hinders ASRs' oral health care were: prioritising safety and survival; variations in cultural norms and practice; lack of knowledge about dental care; financial hardship and affordability of care; a gulf of understanding of what dental care would be like and experiences of it; and structures of dental services that leave vulnerable groups behind. Opportunities for improving oral health care were: accessible oral health education; partnership working and creating supportive environments; translation; providing culturally sensitive and person-centred care; and incorporating ASRs' views into service design.

Conclusions Several factors affect to what extent ASRs can and are willing to engage with oral health care. Co-developing accessible and relevant prevention programmes and ensuring equitable access to dental services for ASRs is important. Future research should explore ASRs' views and experiences of dental care and explore informed suggestions on how to optimise oral health promotion and provision of care.

Key points

  • Several factors affect to what extent asylum seekers and refugees can and are willing to engage with oral health care.

  • Co-developing accessible and relevant prevention programmes and ensuring equitable access to dental services for asylum seekers and refugees is imperative.

  • Incorporating 'cultural competence' into practice can optimise care quality.

  • Future research is needed to explore the views and experiences of asylum seekers and refugees accessing and receiving care in the UK, as well as their recommendations on optimising oral health promotion and care provision.

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Acknowledgements

The authors would like to thank all participants for taking part in the study.

Funding

The study was funded by Peninsula Dental Social Enterprise.

Author information

Authors and Affiliations

  1. Peninsula Dental School, University of Plymouth, Plymouth, UK; School of Nursing and Midwifery, University of Plymouth, Plymouth, UK

    Martha Paisi

  2. Centre for Health Technology, University of Plymouth, Plymouth, UK

    Rebecca Baines

  3. Peninsula Medical School, University of Plymouth, Plymouth, UK

    Hannah Wheat

  4. University College London Hospitals, Pathway Healthcare Charity, London, UK

    Janine Doughty & Sarah Kaddour

  5. The Rotherham NHS Foundation Trust Community Dental Service, Rotherham, UK

    Philip J. Radford

  6. Peninsula Dental School, University of Plymouth, Plymouth, UK

    Eleftheria Stylianou & Rob Witton

  7. School of Nursing and Midwifery, University of Plymouth, Plymouth, UK

    Jill Shawe

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  1. Martha Paisi
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Contributions

Martha Paisi: made substantial contributions to study conception and design and acquisition, analysis and interpretation of data. Drafted the manuscript and revised it critically for important intellectual content. Rebecca Baines: made substantial contributions to the analysis and interpretation of data. Revised the manuscript critically for important intellectual content. Hannah Wheat: made substantial contributions to the analysis and interpretation of data. Revised the manuscript critically for important intellectual content. Janine Doughty: made substantial contributions to the interpretation of data. Revised the manuscript critically for important intellectual content. Sarah Kaddour: made substantial contributions to the interpretation of data. Revised the manuscript critically for important intellectual content. Philip J. Radford: made substantial contributions to the interpretation of data. Revised the manuscript critically for important intellectual content. Eleftheria Stylianou: made substantial contributions to the interpretation of data. Revised the manuscript critically for important intellectual content. Jill Shawe: made substantial contributions to study conception and design. Revised the manuscript critically for important intellectual content. Rob Witton: made substantial contributions to study conception and design. Revised the manuscript critically for important intellectual content. All authors gave final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Martha Paisi.

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The authors declare no conflicts of interest.

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Paisi, M., Baines, R., Wheat, H. et al. Factors affecting oral health care for asylum seekers and refugees in England: a qualitative study of key stakeholders' perspectives and experiences. Br Dent J (2022). https://doi.org/10.1038/s41415-022-4340-5

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