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Service-learning; Community Partnerships; UCSF (Dental care for the

Homeless)”

Steven J. Silverstein, DMD,MPH

Professor, UCSF School of Dentistry

Dental Public Health Seminar

April 15,2007

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Did you pay your taxes today!!

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Who was responsible for developing the 1st clinic in the

US that treated the dental needs of the homeless?

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Who are the Homeless

This publication has been produced by Michelle Clark at the National Maternal and Child OralHealth Resource Center, supported at the National Center for Education in Maternal and Child

Health under its cooperative agreement (MCU-119301) with the Maternal and Child HealthBureau, Health Resources and Services Administration, U.S. Department of Health and Human

Services. June 1999.

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The Department of Housing and UrbanDevelopment (HUD) defines the homeless aspersons who are living on the streets or in shelters, aswell as those who are at imminent risk for becominghomeless.2

Each year an estimated 2 million people in the UnitedStates lack access to a conventional dwelling or residence.3Families with children constitute an estimated 38percent of the homeless population; children accountfor 25 percent of the homeless population.4

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Causes of homelessness include untreated mentalillness, substance abuse and unmet treatment needs,domestic violence, low-paying jobs, changes and cutsin public assistance, and lack of access to affordablehealth care.4

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The Oral Health Status of the Homeless Population

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Persons who are homeless have more grossly decayed and missing teeth than the generalpopulation and even the impoverished population living in residences.5

Homeless persons are 12 times more likely than individuals with stable housing to havedental problems. Persons living in unstable housing, such as a hotel or the residence of afriend or relative, are 6 times more likely to have dental problems.6

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The Oral Health Status of Homeless Children

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More homeless children have never seen a dentist than children from families with lowincomes who were living in houses.7

Among homeless children ages 5 to 9 years, 96 percent required dental care and 44 percenthad pain or infection.8

A Boston survey reported that untreated tooth decay in permanent teeth among homelesschildren in New England was 7.7 times above the regional average.8

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Missing teeth diminish self-esteem and impair an individual’s ability toeat, get a job, and, ultimately, return to mainstream society.1,5,10

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The mission of Project Homeless Connect

is to rally the city to support and create lasting solutions for

homeless San Franciscans.

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Tom Waddell Health Center50 Ivy Street, 94102

415.355.7500

Dental Services for the Homeless Youth Guidance Center (YGC)

375 Woodside Ave.415.753.7800

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Pacific Provides Free Dental Treatment to San Francisco Homeless

(December 14, 2007) - More than 100 homeless San Franciscans received much-needed dental care thanks to volunteers from University of

the Pacific, Arthur A. Dugoni School of Dentistry. Pacific students and faculty provided free dental services during

San Francisco's 19th Project Homeless Connect on Dec. 5 

For the first time, Project Homeless Connect transported its clients to the dental clinics at the Arthur A. Dugoni School of Dentistry in order to serve a large number of patients

and have access to state-of-the-art facilities.

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UCSF School of Dentistry Dental Care for the Homeless

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In early 1993, a group of UCSF dental students joined the medical students who had been running a homeless health

clinic at the South of Market Shelter at Fifth and Bryant Street. The idea to add dental care to the services provided

by the clinic came from a second year medical student

Linda Kajisa (who had a DDS degree from UCSF).

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A collaboration between faculty, residents, students, and volunteers, Tom Waddell Health Center / UCSF Community Health Clinic has been working to improve the health of homeless San Franciscans for over a

decade.

The philosophy of the Dental Clinic is to motivate patients to seek healthcare and to prevent dental disease through education and

preventive dentistry. The Dental Clinic is guided by three mutually supportive sets of aspirations:

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.....For the clientsTo provide oral health education, referrals, and treatment. To make a

positive impact on the lives of the homeless people.

.....For the studentsTo create a setting in which students can learn, teach, and practice

clinical skills. To cultivate sensitivity and comfort in interactions with the underserved population.

.....For the Community

To use the Dental Clinic as a forum for education and health care service. To promote advocacy for the needs of this population.

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Why on this night is the UCSF Program for the Homeless

different from other programs?

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It is student run!!!

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Student President

Student Co-ordinators

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Issues!

1. Only free care in the school2. Only program where all 4 years of students work together.3. Not comprehensive treatment4. Treatment is confined to simple restorative and periodontal procedures. 5. Elective6. TB7. Homeless in the building at night.8. Out of the mainstream.