Dental emergencies rarely begin as emergencies. Most severe oral infections start as small, preventable cavities. Mild gum inflammation becomes advanced periodontal disease. A minor lesion progresses until pain forces an emergency department visit.
For individuals experiencing homelessness in San Diego County, this progression is common — not because prevention is ineffective, but because prevention is often inaccessible.
Across the United States, dental-related emergency department visits cost billions annually. According to the American Dental Association Health Policy Institute, many of these visits involve conditions that could have been prevented with earlier intervention. Emergency departments typically provide pain management, antibiotics, and referral instructions — not definitive restorative dental care.
Tooth decay is a progressive disease process. The CDC identifies dental caries as the most common chronic disease of childhood, and untreated decay persists into adulthood. This progression is predictable, which means it is preventable.
For individuals experiencing homelessness, limited storage for hygiene supplies, difficulty accessing clean water, and competing survival priorities make daily oral hygiene more challenging. When preventive access is delayed or interrupted, disease severity increases.
Preventive oral health outreach focuses on reducing escalation through fluoride varnish application, Silver Diamine Fluoride to arrest active lesions, oral hygiene instruction, screening for early signs of infection, and referral coordination.
Dental emergencies often result in antibiotic prescriptions. By preventing infection before it escalates, preventive services reduce unnecessary antibiotic exposure, contributing to antimicrobial stewardship.
San Diego County has both challenge and opportunity. Integrating preventive oral health into homelessness response strategies strengthens overall outcomes and advances health equity goals.