AACHEN, Germany: Dental care is vital for well-being and overall health but is sometimes neglected because of certain barriers to accessing dental services. In a recent study, researchers examined the oral health of Ukrainian refugees in Germany and identified some difficulties in accessing dental care in the country. It also investigated the refugees’ mental health state in relation to oral health problems. The study is the first one to cover these topics in the population of Ukrainian refugees in Germany.
According to the UN Refugee Agency, various conflicts, wars and violence resulted in over 40 million refugees and asylum seekers worldwide at the end of 2022. By June 2023, the ongoing war in Ukraine had forced 6.3 million Ukrainian refugees to flee their homes and seek safety. Germany welcomed over one million Ukrainian refugees, which meant new challenges for the healthcare system and, in particular, for dental care.
Oral care often plays a subordinate role for refugees, whose prime concerns are integrating into the host nation, learning a new language, finding sources of income and establishing a normal level of life. Needless to say, this may have an impact on their oral health behaviour and result in issues such as high caries prevalence and untreated teeth.
The study took place between September and December 2022 and included people with Ukrainian citizenship who had escaped their home country because of the war. All participants were required to be at least 14 years old. Ukrainians who had travelled to Germany before the war and were not able to go back to Ukraine were also included. All participants received either a paper-based or a web-based questionnaire that covered topics such as general demographic information, oral health status and practices, access to dental care and stress and anxiety levels. In total, 724 questionnaires were included in the analysis.
The researchers reported that the majority of the participants rated their state of teeth and gingivae as average or better than average. However, a fifth of the participants said they avoided smiling because of their teeth or felt embarrassed owing to the appearance of their teeth. The most frequent limiting factors to accessing dental care were found to be finances (82.6%), language barrier (82.2%) and complicated healthcare system (74.1%).
Additionally, 45.8% of the participants in the study scored ten or more on the Patient Health Questionnaire and 37.4% on the Generalized Anxiety Disorder 7-item scale, respectively, which suggests moderate depression and anxiety. The data also showed that these participants were more likely to report pain and a poor state of teeth and gingivae and to fail a dental consultation.
Overall, 59.6% of the participants reported not consulting a dentist when needed. Failed consultations were associated with a poorer reported state of teeth and gingivae.
The findings indicate a link between mental health and oral health, pointing to the unique needs of Ukrainian refugees. In light of the findings, the researchers believe that dentists should improve their knowledge of post-traumatic syndromes, behavioural sciences and psychology in general, especially in relation to war-affected people.
Further research is required to assess the cultural and medical needs of Ukrainian refugees and to improve their access to dental services.
The study, titled “Oral health, stress and barriers accessing dental health care among war-affected Ukrainian refugees in Germany”, was published online on 27 October 2023 in BMC Oral Health.
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