Oral Health

In refugee populations resettled to the U.S., oral health needs deserve special consideration. For example, among refugees newly arrived in Massachusetts, oral abnormalities are the most common health problem in refugee children, and the second most common problem among refugee adults.[1]

Poor oral health amongst refugees may be a result of a limited diet and lack of access to dental health care in refugee camps, and in some cases may also be a result of torture.[2] In the larger U.S. population, access to preventative and restorative dental services plays an important role in oral health status.[3] Health access is influenced by factors such as limited literacy, socioeconomic status and insurance.[4, 5]

Despite refugees being considered a vulnerable population as a whole, certain refugee demographic groups may have very good oral health status (namely a low prevalence of caries) as a result of excellent oral health practices and a diet with little refined sugar. [6, 7, 8] Programs serving refugees should affirm these practices. As refugees adopt a western diet, they may become more susceptible to poor oral health, particularly if they do not have adequate access to U.S. dental care or have not adopted U.S. oral hygiene guidelines.[7]

Special considerations on arrival:

  • Limited diet and lack of access to oral health care in refugee camp
  • History of torture
  • Effective alternative oral health practices, such as the miswak (a teeth-cleaning twig), which may not be available in the U.S.

Special considerations post-arrival:

  • Lack of access to preventive and restorative dental care
  • Lack of interpretation in dental care settings
  • Unfamiliarity with the dangers of western diet on oral health (e.g., sugar in soda)
  • Potential unfamiliarity with tooth brushing and flossing


1. Cote S, Geltman P, Nunn M, Lituri K, Henshaw M, Garcia RI. Dental caries of refugee children compared with US children. Pediatrics 2004;114(6):e733-40.
2. Singh HK, Scott TE, Henshaw MM, Cote SE, Grodin MA, Piwowarczyk LA. Oral health status of refugee torture survivors seeking care in the United States. Am J Public Health 2008;98(12):2181-2.
3. Garcia RI, Cadoret CA, Henshaw M. Multicultural issues in oral health. Dent Clin North Am 2008;52(2):319-32, vi.
4. The invisible barrier: literacy and its relationship with oral health. A report of a workgroup sponsored by the National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Public Health Service, Department of Health and Human Services. J Public Health Dent 2005;65(3):174-82.
5. Telford C, Coulter I, Murray L. Exploring socioeconomic disparities in self-reported oral health among adolescents in california. J Am Dent Assoc 2011;142(1):70-8.
6. Geltman PL, Hunter Adams, J., Cochran, J, Doros, G, Rybin, D, Henshaw, M, Barnes, L., Paasche-Orlow, M. The Impact of Functional Health Literacy and Acculturation on the Oral Health Status of Somali Refugees Living in Massachusetts. American Journal of Public Health In Press.
7. Marino R, Stuart GW, Wright FA, Minas IH, Klimidis S. Acculturation and dental health among Vietnamese living in Melbourne, Australia. Community Dent Oral Epidemiol 2001;29(2):107-19.
8. Cruz GD, Shore R, Le Geros RZ, Tavares M. Effect of acculturation on objective measures of oral health in Haitian immigrants in New York City. J Dent Res 2004;83(2):180-4.
9. Okunseri C, Yang M, Gonzalez C, LeMay W, Iacopino AM. Hmong adults self-rated oral health: a pilot study. J Immigr Minor Health 2008;10(1):81-8.
10. Okunseri C, Hodges JS, Born DO. Self-reported oral health perceptions of Somali adults in Minnesota: a pilot study. Int J Dent Hyg 2008;6(2):114-8.