Oral health and access to dental care among older homeless adults: results from the HOPE HOME study
Open accessAbstract
Objectives: To describe the prevalence of and factors associated with oral health measures in a sample of older homeless adults in Oakland, CA. Methods: We conducted a cross‐sectional analysis of data from a population‐based study of 350 homeless adults aged ≥50 in which trained researchers conducted structured interviews using validated questions regarding sociodemographics, health‐related behaviors, healthcare utilization, and health status. We assessed self‐reported tooth loss, oral pain, and unmet need for dental care. We used multivariable logistic regression to examine factors associated with missing half or more teeth. Results: Over half 201/350 (57.4 percent) of participants were missing at least half of their teeth. Half 191/350 (54.6 percent) reported oral pain in the past 6 months; 101/350 (28.9 percent) reported that oral pain prevented them from eating and 73/350 (20.9 percent) reported that pain prevented sleeping. Almost half, 141/350 (40.3 percent), had not seen a dentist in over 5 years, and over half 190/350 (54.3 percent) reported being unable to obtain needed dental care. In multivariate models, increased age (AOR = 1.09, 95 percent CI 1.04–1.14), moderate‐to‐high risk alcohol use (AOR = 2.17, CI = 1.23–3.84), moderate‐to‐high risk cocaine use (AOR = 1.72, CI = 1.03–2.88), and ever smoking (AOR = 2.87, CI = 1.59–5.18) were associated with an increased odds of having lost half or more teeth. Conclusions: Tooth loss and oral pain are highly prevalent in older homeless adults. Increasing age, alcohol, drug, and tobacco use are associated with tooth loss.
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Cites
(2001) · Cited by 5,455 · see citing works
Oral Health in America: A Report of the Surgeon General
(2000) · Journal of the California Dental Association · doi:10.1080/19424396.2000.12223118 · Cited by 2,481 · see citing works
(1994) · PubMed · Cited by 2,337 · see citing works
Beltrán‐Aguilar, E. D. (2005) · Medical Entomology and Zoology · Cited by 912 · see citing works
The unmet health care needs of homeless adults: a national study
Baggett, T. P., O'Connell, J. J., Singer, D. E., & Rigotti, N. A. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.180109 · Cited by 552 · see citing works
(2010) · Cited by 476 · see citing works
Beltrán‐Aguilar, E. D., Barker, L. K., Canto, M. T., Dye, B. A., Gooch, B. F., Griffin, S. O., Hyman, J. J., Jaramillo, F., Kingman, A., Nowjack‐Raymer, R. E., et al. (2005) · PubMed · Cited by 456 · see citing works
Edentulism and Comorbid Factors
Felton, D. A. (2009) · Journal of Prosthodontics · doi:10.1111/j.1532-849x.2009.00437.x · Cited by 270 · see citing works
Geriatric syndromes in older homeless adults
Brown, R. T., Kiely, D. K., Bharel, M., & Mitchell, S. L. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1848-9 · Cited by 256 · see citing works
Dental caries and tooth loss in adults in the United States, 2011-2012.
Dye, B. A., Thornton‐Evans, G. O., Xian-fen, L., & Iafolla, T. (2015) · PubMed · Cited by 250 · see citing works
The Age Structure of Contemporary Homelessness: Evidence and Implications For Public Policy
Culhane, D. P., Metraux, S., Byrne, T. H., Stino, M., & Bainbridge, J. (2013) · Analyses of Social Issues and Public Policy · doi:10.1111/asap.12004 · Cited by 201 · see citing works
Geriatric Conditions in a Population-Based Sample of Older Homeless Adults
Brown, R. T., Hemati, K., Riley, E. D., Lee, C. T., Ponath, C., Tieu, L., Guzman, D., & Kushel, M. (2016) · The Gerontologist · doi:10.1093/geront/gnw011 · Cited by 195 · see citing works
Self-citationAccess to dental care among older adults in the United States
Dolan, T. A., Atchison, K., & Huynh, T. N. (2005) · Journal of Dental Education · doi:10.1002/j.0022-0337.2005.69.9.tb03993.x · Cited by 189 · see citing works
Redford, M., Drury, T. F., Kingman, A., & Brown, L. J. (1996) · Journal of Dental Research · doi:10.1177/002203459607502s11 · Cited by 125 · see citing works
Selected oral health indicators in the United States, 2005-2008.
Dye, B. A., Li, X., & Beltrán‐Aguilar, E. D. (2012) · PubMed · Cited by 119 · see citing works
Causal assessment of smoking and tooth loss: A systematic review of observational studies
Hanioka, T., Ojima, M., Tanaka, K., Matsuo, K., Sato, F., & Tanaka, H. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-221 · Cited by 104 · see citing works
Huang, D. L., & Park, M. (2014) · Journal of Public Health Dentistry · doi:10.1111/jphd.12072 · Cited by 90 · see citing works
Effect of cannabis usage on the oral environment: a review
Versteeg, P., Slot, D. E., van der Velden, U., & van der Weijden, G. A. (2008) · International Journal of Dental Hygiene · doi:10.1111/j.1601-5037.2008.00301.x · Cited by 87 · see citing works
Welfare dental intervention improves employment and quality of life
Hyde, S., Satariano, W. A., & Weintraub, J. A. (2006) · Journal of Dental Research · doi:10.1177/154405910608500114 · Cited by 85 · see citing works
Brand, H. S., Gonggrijp, S., & Blanksma, C. J. (2008) · BDJ · doi:10.1038/sj.bdj.2008.244 · Cited by 79 · see citing works
Dutta, S., Orestes, M., Vengulekur, S., & Kwo, P. Y. (1992) · PubMed · Cited by 61 · see citing works
Dental health of homeless adults.
Celberg, L., Linn, L., & Rosenberg, D. (1988) · Special Care in Dentistry: managing special patients, settings, and situations · doi:10.1111/j.1754-4505.1988.tb00725.x · Cited by 61 · see citing works
Oral Health, Related Behaviors and Oral Health Impacts Among Homeless Adults
Conte, M., Broder, H. L., Jenkins, G., Reed, R., & Janal, M. N. (2006) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2006.tb04082.x · Cited by 54 · see citing works
Robbins, J. L., Wenger, L. D., Lorvick, J., Shiboski, C. H., & Kral, A. H. (2010) · Journal of Urban Health · doi:10.1007/s11524-010-9498-5 · Cited by 50 · see citing works
Who Gained Health Insurance Coverage under the ACA, and Where Do They Live?Preprint
Garrett, B., & Gangopadhyaya, A. (2016) · SSRN Electronic Journal · Cited by 43 · see citing works
Chi, D., & Milgrom, P. (2008) · Special Care in Dentistry · doi:10.1111/j.1754-4505.2008.00046.x · Cited by 38 · see citing works
A national survey of the oral health status of homeless veterans
Gibson, G., Rosenheck, R., Tullner, J. B., Grimes, R. M., Seibyl, C. L., Rivera‐Torres, A., Goodman, H. S., & Nunn, M. E. (2003) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2003.tb03471.x · Cited by 35 · see citing works
The cocaine connection. Users imperil their gingiva.
Quart, A. M., Small, C. B., & Klein, R. S. (1991) · PubMed · Cited by 29 · see citing works
Oral health policymaking challenges in Iran: a qualitative approach
Mohammadpour, M., Bastani, P., Brennan, D. S., Ghanbarzadegan, A., & Bahmaei, J. (2020) · BMC Oral Health · doi:10.1186/s12903-020-01148-w · Cited by 26 · see citing works
California Tobacco Survey (CTS)
Pierce, J., Gilpin, E., Emery, S., Farkas, A., Zhu, S., Choi, W., Berry, C., Distefan, J., White, M., Soroko, S., et al. (2015) · UC San Diego · doi:10.6075/j0h41pbm · Cited by 13 · see citing works
California Tobacco Survey (CTS) 2008. In California Tobacco Survey (CTS)
Al-Delaimy, W., Edland, S., Pierce, J., et al. (2015) · UC San Diego · doi:10.6075/j0kw5cx7 · Cited by 5 · see citing works
Flagged first, then by citations
1 of the 32 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Ending the neglect of global oral health: time for radical action.
Watt, R. G., Daly, B., Allison, P., Macpherson, L. M. D., Venturelli, R., Listl, S., Weyant, R. J., Mathur, M. R., Guarnizo-Herreño, C. C., Celeste, R. K., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(19)31133-x · Cited by 1,029 · see citing works
Relationship between consumption of soft and alcoholic drinks and oral health problems
Çetinkaya, H., & Romaniuk, P. (2020) · Central European Journal of Public Health · doi:10.21101/cejph.a5745 · Cited by 44 · see citing works
Oral health policymaking challenges in Iran: a qualitative approach
Mohammadpour, M., Bastani, P., Brennan, D. S., Ghanbarzadegan, A., & Bahmaei, J. (2020) · BMC Oral Health · doi:10.1186/s12903-020-01148-w · Cited by 26 · see citing works
The relationship of aging, complete tooth loss, and having a dental visit in the last 12 months
Sifuentes, A. M. F., Castañeda‐Avila, M. A., & Lapane, K. L. (2020) · Clinical and Experimental Dental Research · doi:10.1002/cre2.309 · Cited by 26 · see citing works
Kim, N., & Kawachi, I. I. (2020) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12594 · Cited by 20 · see citing works
Singh, A., Purohit, B. M., & Taneja, S. (2020) · The Journal of the American Dental Association · doi:10.1016/j.adaj.2020.02.017 · Cited by 18 · see citing works
Health status and health behaviour of the Hungarian homeless people
Nagy-Borsy, E., Vági, Z., Skerlecz, P., Szeitl, B., Kiss, I., & Rákosy, Z. (2021) · Archives of Public Health · doi:10.1186/s13690-021-00534-2 · Cited by 11 · see citing works
Durey, A., Lette, H., Saunders, J., & Slack-Smith, L. M. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.14070 · Cited by 9 · see citing works
Freire, M. D. C. M., Lawder, J. A. D. C., de Souza, J. B., & de Matos, M. A. (2021) · Journal of Public Health Dentistry · doi:10.1111/jphd.12452 · Cited by 9 · see citing works
Prevalence of toothache in Chinese adults aged 65 years and above
Wan, S., Tao, L., Liu, M., & Liu, J. (2021) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12640 · Cited by 9 · see citing works
Economic evaluation of a community dental care model for people experiencing homelessness
Nguyen, T. M., Witton, R., Withers, L., & Paisi, M. (2024) · BDJ · doi:10.1038/s41415-024-8166-1 · Cited by 7 · see citing works
Bernardino, R. M. P., Silva, A. M., Costa, J. F., SILVA, M. V. B., dos Santos, I. T., Neta, N. B. D., Júnior, R. R. P., & Mendes, R. F. (2021) · Brazilian Oral Research · doi:10.1590/1807-3107bor-2021.vol35.0107 · Cited by 8 · see citing works
Differences in Utilization of Medical and Dental Services among Homeless People in South Korea
Lee, S., Ryu, J., & Jung, S.-H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17155304 · Cited by 9 · see citing works
Oral Health Epidemiological Investigation in an Urban Homeless Population
Lione, R., Ralli, M., Razza, F. C. D., D’Amato, G., Arcangeli, A., Carbone, L., & Cozza, P. (2024) · Dentistry Journal · doi:10.3390/dj12100324 · Cited by 6 · see citing works
Unmet dental care needs of homeless adults in South Korea: Findings from a national survey
Che, X., Sohn, M., Moon, S., & Park, H. (2021) · Health & Social Care in the Community · doi:10.1111/hsc.13521 · Cited by 6 · see citing works
Venturelli, R., Blokland, A., Tsakos, G., Stennett, M., Makhani, S., Jones, K., Watt, R. G., & Heilmann, A. (2025) · BDJ · doi:10.1038/s41415-025-8916-8 · Cited by 4 · see citing works
Dolman, A. J., Kaliappan, S., Zhou, Y., Palleti, D., Marquard, J. L., Lee, S. I., Karkar, R., & Jimison, H. B. (2025) · Innovation in Aging · doi:10.1093/geroni/igaf106 · Cited by 4 · see citing works
Emerging supramolecular and living materials in oral medicine
Fischer, N. G., Lin, T.-Y., Xiang, Y., Sang, T., & Ye, Z. (2025) · Trends in biotechnology · doi:10.1016/j.tibtech.2025.03.006 · Cited by 4 · see citing works
Sleep Health in People Experiencing Homelessness: A Scoping Review
Edmed, S. L., de Waal, L., Rossa, K. R., Pattinson, C. L., Salom, C., Gadam, S., Lorimer, N., & Smith, S. S. (2025) · Health & Social Care in the Community · doi:10.1155/hsc/8766803 · Cited by 3 · see citing works
Extracting Social Determinants of Health from Dental Clinical Notes
Pethani, F., Chapman, A. B., Conway, M., Dai, X., Bishay, M. D., Choh, M. V., He, A., Lim, S.-E., Ng, H. Y., Mahony, T., et al. (2025) · Applied Clinical Informatics · doi:10.1055/a-2616-9858 · Cited by 3 · see citing works
Diet and Nutrition and Their Relationship with Early Childhood Dental Caries
Ferreira, L. G., Lamarque, G. D. C. C., & Paula‐Silva, F. W. G. (2022) · Dentistry · doi:10.5772/intechopen.105123 · Cited by 2 · see citing works
ANÁLISE DA CONDIÇÃO DE SAÚDE BUCAL DA POPULAÇÃO EM SITUAÇÃO DE RUA DO MUNICÍPIO DE NATAL-RN
Martins, S. S. D. S., & da Silva, E. M. (2019) · Revista Ciência Plural · doi:10.21680/2446-7286.2019v5n3id18647 · Cited by 3 · see citing works
Radó, N., Németh, O., & Békási, S. (2025) · JMIR Formative Research · doi:10.2196/68316 · Cited by 1 · see citing works
Simon, L. E., Marsh, R. H., Sánchez, L. D., Camargo, C. A., Donoff, R. B., Cardenas, V., Manning, W., Loo, S. S., Cash, R. E., & Samuels‐Kalow, M. E. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-078157 · Cited by 1 · see citing works
Gomes, A. T. P. C., Mendes, K., Ferrito, C., Andrade, F., Neves‐Amado, J., Resende, A., Santos, P., Manso, D., Almeida, A., Vollrath, A. A., et al. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1432044 · Cited by 1 · see citing works
Salud bucal de personas en situación de calle: Una revisión sistemática
Araque, M., Chacón, R., Lujano, H., Maldonado, A., Márquez, J., & Meza, A. (2021) · Revista de Investigación Docencia y Extensión de la ULA (IDEULA) · doi:10.53766/ideula/2021.01.01.01
Satisfaction with oral health and associated factors among homeless people in Midwest Brazil
Freire, M. D. C. M., Lawder, J. A. D. C., de Souza, J. B., & de Matos, M. A. (2021) · Oral Diseases · doi:10.1111/odi.13976
Escala de vulnerabilidade odontológica em atenção primária à saúde
Palácio, D. D. C. (2020) · doi:10.47749/t/unicamp.2020.1164487
Doroshenko, O. M., & Shepelynskyi, O. (2024) · SUCHASNA STOMATOLOHIYA · doi:10.33295/1992-576x-2024-3-44
Radó, N., Németh, O., & Békási, S. (2024) · doi:10.2196/preprints.68316
Additional file 1 of Health status and health behaviour of the Hungarian homeless people
Nagy-Borsy, E., Vági, Z., Skerlecz, P., Szeitl, B., Kiss, I., & Rákosy, Z. (2021) · Figshare · doi:10.6084/m9.figshare.13698291
Paisi, M., Rodriguez, A., & Withers, L. (2026) · BDJ · doi:10.1038/s41415-025-9251-9
Cronin, T., Smith, S. M., & Travers, J. (2026) · PLoS ONE · doi:10.1371/journal.pone.0343369
Experiences of Food and Mealtimes Among People Living in Homelessness
Hjorth, E., Doveson, S., Klarare, A., & Wallin, V. B. (2026) · Global Qualitative Nursing Research · doi:10.1177/23333936261450410
Dental Care Needs and Treatment Priorities in a Homeless Population in Rome: An Observational Study
Lione, R., Razza, F. C. D., Morello, R., Ralli, M., D’Amato, G., Romano, G., Mancini, M., & Cozza, P. (2026) · Dentistry Journal · doi:10.3390/dj14060330
Barriers to Cancer Care Among People Experiencing Homelessness in Chicago
Uddin, I. A., Mohiuddin, S., & Mohiuddin, M. M. (2026) · Cureus · doi:10.7759/cureus.110465
Oral Health and Associated Factors Among Brazilian Homeless: Evidence from a Vulnerable Population
Sales, G. B., Borborema, M. L. D., Neto, E. M. D. L., de Melo, L. P. M., Bronzeado, I. L. S., Cavalcanti, A. L., & Cavalcanti, A. F. C. (2026) · Pesquisa Brasileira em Odontopediatria e Clínica Integrada · doi:10.1590/pboci.2026.098
de Queiroz, G. V. R., Silva, T. B. D. V., & Batista, M. J. (2026) · Epidemiologia e Serviços de Saúde · doi:10.1590/s2237-96222026v35e20240124.pt
de Queiroz, G. V. R., Silva, T. B. D. V., & Batista, M. J. (2026) · Epidemiologia e Serviços de Saúde · doi:10.1590/s2237-96222026v35e20240124.en
Malhotra, S., Faraz, D. M. A., Shukla, S., & Zehra, C. (2026) · Cureus · doi:10.7759/cureus.115990
Torres, D., Rinker, D., Ojeda, M., Hebert, S., & Silk, H. J. (2026) · Journal of Social Distress and the Homeless · doi:10.1080/10530789.2026.2746130
- Authors
- Freitas, D. J., Kaplan, L. M., Tieu, L., Ponath, C., Guzman, D., & Kushel, M.
- Affiliations
- University of California, San Francisco (US)
- San Francisco General Hospital (US)
- Corresponding author
- Kushel, Margot
- Venue
- Journal of Public Health Dentistry
- Publisher
- Wiley
- Published
- 2018-09-17
- Volume
- 79
- Issue
- 1
- Pages
- 3-9
- ISSN
- 0022-4006 (ISSN-L)
- 1752-7325
- PMC
- PMC6420347
- OpenAlex
- W2889729781
- Cited by
- 43
- References
- 32
- Citations by year
- 2026: 12 · 2025: 6 · 2024: 5 · 2023: 1 · 2022: 2 · 2021: 8 · 2020: 7 · 2019: 2
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Public Health Dentistry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (P30AG044281, R01AG041860, K24AG046372)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Keywords
- oral health, homeless adults, older adults, tooth loss, oral pain, unmet dental care needs, access to dental care, alcohol consumption, cocaine use, smoking
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Dental Care, Ill-Housed Persons, Humans, Oral Health, Tooth Loss
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