Oral health experiences of refugee children, and their parents' perspectives on access to oral health care

BackgroundRefugeed persons are people who have migrated to evade harsh conditions in their home country, such as environmental disasters, violence, and war. Although refugeed persons often resettle well in Canada, many still face numerous issues upon their arrival, including adapting to a new society, learning a new language, finding a job, and navigating the healthcare system of the host country. In Quebec, refugeed children experience a high prevalence of oral-related conditions. Nevertheless, research has not yet fully explored how they experience oral health and oral health care or how their parents experience accessing oral health care for them. Given this concerning scenario, the goal of this study was to shed more light on these issues to improve their access to oral health care.Research QuestionsHow do refugeed children in Montreal understand oral health and experience oral health care, and how do refugeed parents experience accessing oral health care for their children?MethodsWe used a qualitative description methodology for our study. Participants included refugeed children aged 6–12 years and their parents. They were recruited from the Immigrant and Refugee Pediatric Dental Clinic at the Montreal Children’s Hospital (MCH), the only institution in Montreal that provides comprehensive free dental care for refugeed children. We conducted individual, semi-structured interviews with 11 children and 11 parents; the children and their parents were interviewed separately. Data generation and data analysis occurred concurrently. Data were analyzed using a thematic approach, including interview debriefing, transcript coding, data display, and interpretation.ResultsOur findings include five main themes: 1) The children’s reflections on their mouths; 2) Experiences of children at the dental clinic; 3) Parents’ understandings of oral health; 4) Experiences of parents prior to finding oral health care for their children; 5) Experiences of parents after finding oral health care for their children.Refugeed children linked oral health to dental appearance (e.g., teeth color and alignment) and symptoms such as tooth pain and halitosis. They also associated oral health with preventive care, including diet, oral hygiene, and dental visits. When describing their experiences at the dental clinic, most responses were positive, and the children stated they were willing to visit the dentist again. However, discomfort during dental treatment and fear of pain during dental procedures made some children apprehensive of follow-up visits.The parent participants understood and valued the importance of oral health, albeit they lacked knowledge about oral health coverage and information regarding institutions that provide care tailored for refugeed persons. The parents also reported facing barriers related to transportation, limited dental coverage, and language, although they also expressed their satisfaction with the services provided at the Immigrant and Refugee Dental Clinic at the Montreal Children’s Hospital. This satisfaction was associated with its cleanliness, the quality of the equipment, short waiting times on the day of the appointment, and the staff’s understanding and polite behavior.ConclusionOur findings are useful for oral health care providers and institutions involved with refugeed persons. When informed about the challenges experienced, as well as the positive experiences of, refugeed persons, oral health care providers and institutions will be better placed to improve access for them. Moreover, our findings can help alert government and community bodies about the importance of better informing and guiding refugeed persons to access dental services. Further research should focus on the perceptions of oral health care providers involved with refugeed children in order to understand their experiences and their suggestions for improving access and oral health care

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