Dental care offers street sex workers 'a lifeline'

A new outreach project is helping street sex workers access dental care, giving them "a lifeline", according to practitioners.

The initiative, run by Gloucestershire charity Bridge2Aid and Bristol Dental School (BDS), aims to break down barriers preventing women from visiting a dentist.

Bridge2Aid chief executive Shaenna Loughnane said many women had no fixed address or income, had experienced trauma to the face and mouth and often felt judged when seeking care.

Karen, not her real name, who has received treatment through the scheme, said: "They were so kind, they took their time and it felt safe."

BDS said the programme was the first in the UK to provide treatment for street sex workers.

Karen lives in Bristol and was offered treatment through Bridge2Aid. She said being treated with dignity at BDS made a huge difference.

"One of the biggest challenges for me is I have a history of sexual trauma, so that causes a lot of anxiety kind of just having a dentist that close to you," she said.

Karen said other factors can put the women off going to the dentist, such as unusual working hours and addiction.

"Street sex working is a very chaotic lifestyle and it can be difficult to do things like appointments in the day because often you're out late.

"If you haven't had your drugs you're not going to get there and a lot of people are very judgemental to that," she said.

BDS students said the programme had given them a better understanding of the barriers some street sex workers face when accessing healthcare.

One dental student said she was surprised to learn that some women had no access to clean water, something she had not previously considered when thinking about oral health advice.

"It's important to take into consideration a person's lifestyle when planning care, for example, booking appointments in the afternoon as the [women] may be working in the night.

"We felt grateful to have been allowed into a space that has clearly been a lifeline to many. It was an eye-opening visit," she said.

Shaenna said many of the women feel unwelcome just walking through the door of a dental practice and often felt judged.

"Once they've been through the door once or twice with us, hopefully that will mean they'll be able to make further appointments and have sustainable care," she said.

"We've had feedback from the clients and one of the questions was, 'were you treated with dignity and respect?' and 100% of the women said yes."

Bridge2Aid works closely with another Bristol-based charity, One25, which supports women involved in street sex work in the city.

Head of services at One25, Rachel Collins-White, said several women had had treatment ranging from x-rays and fillings to tooth extractions and dentures - and she hoped more sex workers could be helped in future.

"They spoke about how supportive, understanding and compassionate the students were - unfortunately women do not often receive such kind treatment.

Emily - not her real name - is due to start extensive treatment at BDS.

"Years ago, when I first got kicked out of my home, I was in a bed and breakfast and I didn't have access to toothpaste and I ended up getting something called trench mouth [a severe gum infection]."

Now a member of One25's lived experience group, Emily said it was reassuring that she would be seeing the same dental student throughout her treatment and that it was "an amazing thing to get your quality of life back".

"To find out that you can get quite severe illnesses from not having proper oral hygiene, and to try and nip that in the bud as early as possible for these women who may not even be able to access clean water, is amazing."

BDS said it was important that students had a broad education working with underserved populations.

Joint clinical lead of the general practice unit at BDS, Phil Loughnane, said the programme was very much "pushing boundaries" .

"The students have found it really effective learning, and very rewarding being the person to complete the treatment for these women," he said.

"There's been work done in Liverpool with street sex workers to outline their treatment needs, but this is innovative as we're giving actual practical treatment because ultimately that's the thing that the women find hard," he added.

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