Through a variety of programs, community partnerships, and services, the Los Angeles County (LAC) Department of Public Health (DPH) works to advance the conditions that support optimal health and well-being for all persons in LAC. LAC DPH's vision is Healthy People in Healthy Communities. Los Angeles County, the most populous county in the United States, encompasses over 4,000 square miles, has 88 incorporated cities, about 130 unincorporated areas, and is home to a racially, culturally, and linguistically diverse population of nearly 10 million. In 2021, 48% were Hispanic/Latinx, 28% were White, 16% were Asian, and 8% were Black/African American.[1]
As with many large urban areas, LAC is challenged with a growing population of people experiencing homelessness (PEH). In September, the Los Angeles Homeless Services Authority (LAHSA) released the results of the 2022 Homeless Count. There are nearly 69,150 PEH in LAC which is a 4.1% rise compared to 2020.[2] PEH populations are particularly vulnerable to barriers regarding access to health care including oral health care. Oral health conditions such as missing teeth and tooth decay may contribute to anxiety and insecurity when engaging in social activities, seeking or retaining employment, and could lead to a reduced quality of life.[3] In LAC, 34% of adults 18+ have had a permanent tooth removed due to dental disease and lower income adults are significantly more likely to have missing teeth compared to higher income adults.[4] There is a high prevalence of missing teeth and need for removable dentures among PEH.[5]
LAC DPH's Oral Health Program (OHP) strives to foster a community where oral health is recognized as essential for overall health and where everyone has the opportunity to achieve optimal health and well-being. OHP explored and invested in an innovative way to address some of the challenges PEH face in obtaining dental care through the Temporary Dentures for People Experiencing Homelessness project. OHP partnered with Western University College of Dental Medicine (Western), a local YMCA and Lava Mae, a non-profit organization that provides mobile showers and hygiene services to PEH, to launch a dental internship program. Through this internship, PEH can receive temporary partial dentures in one appointment. In addition, clients receive oral hygiene instruction and dental resources. The services are provided at the Lava Mae mobile shower site located at the Weingart East Los Angeles YMCA, a site that is well-known and frequented by the PEH community.
The project goals are two-fold: 1) to increase access to dental services by providing dental care in a location where vulnerable populations are also receiving other essential services such as meals, clothing, and showers and 2) to increase the dental workforce in community-based settings by exposing students to working with underserved populations and encouraging the continuation of work in underserved communities after graduation. This model was made possible by leveraging partnerships to increase equitable access to care for the most vulnerable in our community to address their unmet oral health needs.
[1] http://publichealth.lacounty.gov/epi/docs/2021-LAC-Population_Provisional.pdf
[2] The Los Angeles Homeless Services Authority, 2022 Greater Los Angeles homeless count.
[3] https://nhchc.org/wp-content/uploads/2021/07/OH-and-BH_NHCHC-NNOHA-6.2.21162.pdf
[4] Behavioral Risk Factor Surveillance System (BRFSS), 2020, https://www.cdc.gov/brfss/brfssprevalence/
[5] Seirawan H, Elizondo LK, Nathason N, Mulligan R. The oral health conditions of the homeless in downtown Los Angeles. J Calif Dent Assoc 2010; 38(9): 681-8