Considerations in establishing a dental program for the homeless.

The homeless are a diverse group who present the dental profession with a number of difficult challenges in the delivery of oral health services. Utilization of dental services by the homeless is low when provided in traditional settings and access is limited. The purpose of this case study is to review program planning issues focusing on the unique aspects of establishing dental programs for the shelter-based homeless. This paper is based on experiences in developing a dental program for homeless persons in Boston. The establishment of a portable dental program in 1988 for persons residing in shelters in the greater Boston area involved many administrative and clinical considerations. These factors included determination of needs and barriers to dental care, resource identification and development, program planning and implementation, evaluation, and the development of constituency support. The diversity of the homeless population in combination with the variation of space and medical resources at different shelter sites dictates flexibility in the development of programs to address the oral health needs of the homeless.