Homelessness in San Diego County is often discussed in terms of housing supply, mental health services, and employment pathways. But one essential dimension of health frequently receives less attention: oral health. Dental disease does not pause during housing instability.
National data consistently show that individuals experiencing homelessness have significantly worse oral health outcomes compared to the general population. Research published in the Journal of Health Care for the Poor and Underserved documents higher rates of untreated dental decay, increased periodontal disease, greater tooth loss, and lower rates of routine preventive care.
The traditional dental care model assumes stable housing, reliable transportation, access to communication, insurance literacy, and ability to take time off for appointments. For many individuals experiencing homelessness, these assumptions do not reflect reality. Coverage does not automatically equal access.
When preventive access is limited, emergency departments often become the default. The American Dental Association Health Policy Institute estimates billions of dollars in annual spending on dental-related emergency department visits nationwide.
If prevention remains tied exclusively to fixed-site clinics, inequities will persist. Mobile and community-based prevention models adapt to real-world conditions, delivering services directly within temporary housing facilities, shelter programs, outreach sites, and community resource centers.
Prevention-based outreach may include oral health screenings, fluoride varnish application, Silver Diamine Fluoride to arrest active decay, education on oral hygiene practices, and referral coordination. Each of these interventions is supported by evidence.
Research supported by NIH and referenced in the U.S. Surgeon General's report highlights connections between oral inflammation and broader systemic health outcomes, including diabetes management, cardiovascular disease associations, and chronic inflammatory burden.
Prevention-based oral health outreach among unhoused communities is not charity dentistry. It is public health infrastructure. By reducing untreated decay and infection, prevention reduces emergency department utilization, lowers public expenditure, and improves population health metrics.