Too many homeless people resort to pulling their own teeth. These dentists are trying to change that

A dental surgery on wheels is hitting the UK’s streets to help people facing homelessness with their teeth.

The team of dentists and nurses pop up near hostels to bring care directly to vulnerable people who may be suffering with pain in their teeth or who simply want to feel more confident with their smiles.

It is run by charity Dentaid and funded by the Bupa Foundation, who work with charities including the Single Homeless Project to reach the people who need their help most.

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“It is a pretty comprehensive dental surgery. We can provide X-rays. We can do tooth extractions. We can do fillings,” says Neil Sikka, director of dentistry at Bupa.

Inside, the van looks much like an average dental surgery – the key difference is that it comes directly to people and offers a compassionate and tailored service for free.

Nearly one in three (30%) people facing homelessness are currently experiencing dental pain, according to homelessness charity Groundswell. Seven in 10 have reported lost teeth since becoming homeless, and 15% have pulled out their own teeth. 

“A lot of our work is getting people out of pain,” Sikka says, speaking from the van which has based itself near the Single Homeless Project’s hostel in Westminster on the day Big Issue visits.

One man who comes into the mobile dentist has recently had a bike accident, and he admits he recently had to pull out a tooth himself because he was in such pain. The dentists and nurses give him a full check-up, clean his teeth and reassure him that his mouth healthy.

Another hostel resident admits he has not been to a dentist in more than a decade and needs to have a tooth pulled out. The team treats him on the spot.

Andy Evans, the chief executive of Dentaid, says: “This is a population that always struggles to access routine care. They need a bespoke service provided to them. The last thing they want is toothache, so if we can help people get out of pain, have a bit more confidence with their oral health, and provide some reassurance, it helps.”

Dentaid also provides services at women’s refuges and food banks, and for people experiencing other health inequalities. Evans explains that poverty can sometimes lead to people having a high-sugar diet, because fresh and nutritious food is often more expensive.

Meanwhile, drugs and alcohol can have a “detrimental effect on the mouth”, despite being commonly used to manage pain in the mouth. More than a quarter (27%) of people facing homelessness have used alcohol to deal with dental pain and even more (28%) have used drugs, Groundswell has found.

In the hours the van sits near the hostel in Westminster, multiple people approach to ask how they could get support. Dentaid only takes on patients who have been referred by its charity partners, so that people most in need get help, but it’s a sign of the high level of demand for free dental advice. 

More than nine in 10 people who are not already registered with an NHS dentist are unsuccessful when they try to get a dental appointment on the NHS, according to the Office for National Statistics.

“It’s particularly hard to access NHS dentistry, especially for this cohort of patients because they need time. They need longer appointments. They tend to have a more complicated medical history,” Evans explains. “Ideally, this should be an NHS funded service bespoke for this client, and that’s kind of where we want to position ourselves.”

Dentaid’s empathetic approach can make a trip to the dentist seem much less daunting, which is especially important for vulnerable and marginalised groups.

Sikka says: “There was one gentleman that we treated, and afterwards he said: ‘I’ve spent my life being homeless, not really thinking anyone cares about me, and you guys have made me feel like a prince.’ To see how just a bit of kindness and care could make such a difference to someone’s life was amazing.”

They aim to return to the hostels as regularly as they can so that people know that they can get continued dental care. But until recently, it was too costly to take the van into London because it did not comply with the rules of the Ultra Low Emission Zone (ULEZ). 

The Bupa Foundation provided funding for a low-emissions, solar-powered and ULEZ-compliant vehicle, which has been named Clover.

“Clover is not only here to provide brilliant care and help people relieve pain that they might have, but also we’re doing that dentistry in a way that is much greener,” says Anna Russell, the director of the Bupa Foundation. 

That has made a significant difference. “It means we can now get into city centres we previously couldn’t really afford to access, and I think that’s going to really change the way we can deliver care right in the heart of places where people think there’s a lot of availability, but there isn’t,” Sikka says.

Russell explains that Sikka, who has worked as a dentist for more than 30 years, “gives up a huge amount of time and energy, both in terms of providing dental care to people that need it but also in the support he gives to Dentaid and their mission.”

But for Sikka, it is an honour to be able to use his skills as a dentist to ease people’s pain.

“I’ve been doing this for many years now, and we’re very fortunate,” Sikka adds. “We work in a profession where we’re helping to improve people’s lives, and we do that every day, but when we do it in a situation like this, where people are really suffering in pain, and have no access to any sort of dental care, it’s a real privilege to be able to help.”

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