Inequity of Access to Oral Healthcare among Asylum Seekers and Refugees, Wales, UK

Background

Oral health is a core component of population health with oral diseases largely preventable, yet dental problems represent the second highest unmet health need among asylum seekers and refugees. High levels of dental caries and periodontal disease reflect exposure to adverse social determinants of health, including poverty, disrupted care pathways, and limited access to preventive services. Asylum seekers and refugees continue to experience structural barriers, scarcity of dental provision and low oral health literacy. The aim of this study therefore was to understand the barriers experienced by asylum seekers and refugees in Wales and to identify the strategies to address them.

Methods

A qualitative study was conducted using semi‑structured interviews with support-workers (n = 10) and a World Café involving support-workers and asylum seekers and refugees (n = 26). Data were thematically analysed, with investigator triangulation to enhance analytical rigour.

Results

Participants reported a high burden of untreated dental diseases, and limited access to oral health care. Barriers included lack of dentists, and transport problems linked to dispersed accommodation. Language issues, limited interpreting, culturally specific diets and practices, inconsistent messaging, and stigma further reduced engagement. Low oral health literacy and the effects of trauma diminished preventive behaviours and help‑seeking. Suggested interventions included culturally tailored oral health education, clear and consistent access to information, peer‑led oral‑health champions, and integration of oral health within mental health, wellbeing, and social prescribing pathways.

Conclusions

Oral health inequities among this population group represent a significant and preventable public health issue. Culturally responsive, co-designed, preventive‑focused interventions, can improve oral health behaviours, reduce emergency presentations, and shift demand toward preventive care.

Key messages

• To empower asylum seekers and refugees to maintain their oral health and to understand how to access oral healthcare.

• To co-design tailored culturally specific oral health interventions with a focus on prevention to be tested and implemented across Wales.