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  1. 1. 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
  2. 3. Did you pay your taxes today!!
  3. 4. Who was responsible for developing the 1 st clinic in the US that treated the dental needs of the homeless?
  4. 6. Who are the Homeless This publication has been produced by Michelle Clark at the National Maternal and Child Oral Health 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 Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. June 1999.
  5. 7. The Department of Housing and Urban Development (HUD) defines the homeless as persons who are living on the streets or in shelters, as well as those who are at imminent risk for becoming homeless.2 Each year an estimated 2 million people in the United States lack access to a conventional dwelling or residence.3 Families with children constitute an estimated 38 percent of the homeless population; children account for 25 percent of the homeless population.4
  6. 8. Causes of homelessness include untreated mental illness, substance abuse and unmet treatment needs, domestic violence, low-paying jobs, changes and cuts in public assistance, and lack of access to affordable health care.4
  7. 9. The Oral Health Status of the Homeless Population
  8. 10. Persons who are homeless have more grossly decayed and missing teeth than the general population and even the impoverished population living in residences.5 Homeless persons are 12 times more likely than individuals with stable housing to have dental problems. Persons living in unstable housing, such as a hotel or the residence of a friend or relative, are 6 times more likely to have dental problems.6
  9. 11. The Oral Health Status of Homeless Children
  10. 12. More homeless children have never seen a dentist than children from families with low incomes who were living in houses.7 Among homeless children ages 5 to 9 years, 96 percent required dental care and 44 percent had pain or infection.8 A Boston survey reported that untreated tooth decay in permanent teeth among homeless children in New England was 7.7 times above the regional average.8
  11. 13. Missing teeth diminish self-esteem and impair an individual’s ability to eat, get a job, and, ultimately, return to mainstream society. 1,5,10
  12. 14. The mission of Project Homeless Connect is to rally the city to support and create lasting solutions for homeless San Franciscans.
  13. 15. Tom Waddell Health Center 50 Ivy Street, 94102 415.355.7500 Dental Services for the Homeless Youth Guidance Center (YGC) 375 Woodside Ave. 415.753.7800
  14. 16. 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.
  15. 17. UCSF School of Dentistry Dental Care for the Homeless
  16. 18. 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).
  17. 19. 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:
  18. 20. .....For the clients To provide oral health education, referrals, and treatment. To make a positive impact on the lives of the homeless people. .....For the students To 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.
  19. 22. Why on this night is the UCSF Program for the Homeless different from other programs?
  20. 23. It is student run!!!
  21. 24. Student President Student Co-ordinators
  22. 25. Issues! 1. Only free care in the school 2. Only program where all 4 years of students work together. 3. Not comprehensive treatment 4. Treatment is confined to simple restorative and periodontal procedures. 5. Elective 6. TB 7. Homeless in the building at night. 8. Out of the mainstream.