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We assessed the oral health status of 216 refugee torture survivors seeking care at an urban torture treatment center in the United States. Results showed that patients' dental health ranged from poor to fair; 76% had untreated cavities, and approximately 90% required immediate or near-immediate dental care. Torture treatment centers, in addition to offering safe environments for educating and examining patients, are ideal settings to provide basic oral health services without the risk of retraumatization. (Am J Public Health. 2008;98:2181-2182. doi:10.2105/AJPH.2007.120063)
Torture survivors who migrate to the United States as refugees or asylum seekers often have unique health needs and problems, including dental needs. Frequently these individuals had only limited access to dental care in their native countries, or such care was completely unavailable. During their migration to the United States, they may encounter poor nutrition and lack of medical or dental care. In refugee camps, overcrowding, violence, and stress may worsen existing health conditions or allow new conditions to develop.
Although dental examinations should be part of their periodic health screenings, dental care is frequently withheld from detained individuals, allowing cavities, abscesses, and gingivitis to worsen. Moreover, application of electrical current or forcing of objects into the mouth during torturemay injure the oral cavity, jaw, and teeth.1
Once torture survivors have relocated to the United States, their ability to obtain care is hindered by the cost of dental services,2 their low socioeconomic status and typically limited English-language proficiency, and their minority status with its adverse social and cultural implications.3,4 We assessed the oral health status of torture survivors seeking care at a torture treatment facility in a large US urban medical center from 2002 through 2006.
METHODS
At the Boston Center for Refugee Health and Human Rights (hereafter "the center"), an outpatient clinic that is part of the Boston Medical Center, a multidisciplinary team provides comprehensive medical, legal, and social services to torture survivors regardless of their legal status. Because concerns about unmet dental needs among patients, the center initiated an oral health program offering screenings and referrals. During the general intake process, patients' primary care or mental health provider asks them whether they are having any difficulty with their teeth or gums and schedules an appointment...