Learning Objective #1: Identify causes of oral health disparities in homeless children

Learning Objective #2: Describe interventions to decrease oral health disparities in homeless children

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Introduction: Dental Caries, the most common infectious disease of children, is five times more prevalent than Asthma. The Surgeon General's report, Oral Health in America, declared dental caries the “silent epidemic” with the worst oral health found among the poor of all ages. The majority of children/adolescents in the United States who experience dental decay are from low-income, minority families. Results of previous oral health studies of homeless children provide compelling evidence that disparities in oral health status between poor or homeless and affluent or non-homeless children exist with tooth decay in homeless children being several times higher than in children of low income who live in houses. The purpose of this paper is to: 1) introduce the nurse to the critical oral health needs of poor and homeless children, 2) illustrate how the nurse can address those needs, and 3) describe a demonstration project that highlights a nurse managed shelter-based clinic as an entry point into the dental system for homeless children. Method: A descriptive method using the Omaha Classification System provided data about the oral health of homeless children seen in a shelter-based clinic. Results: Of the total number of children assessed in a 24 month period (n=264), 22.7% (n=60) had obvious gross dental caries. The school age children (6-12 years) (n=41) had the highest prevalence of dental caries (34%). Discussion: Consistent with the literature, dental caries were the most prevalent condition of homeless children and the most difficult to obtain treatment. A Pediatric Nurse Practitioner (PNP) at a shelter improved access to dental care for children.