Migrant oral care needs: public health service vs. charitable organization, Rome

Aim:To provide an accurate profile of cultural diversity in customs and needs for dental care among immigrants in Rome, Italy. Collecting data on immigrant populations and their health needs is crucial, in order to develop effective care delivery.Methods: A questionnaire was used between September 2006 and March 2007, for out-patients, at their first visit to two primaryoral health care clinics (national public health service - NPHS and a charitable organisation - CO) in Rome. Socio economicstatus (SES), access to general and oral health care and OHRQoL were assessed. Illegal immigrants were classified wherethey did not have a personal identification card. Verbal consent of respondents was recorded. Permission of the Director of theDepartment of Stomatology and Dental Clinic Caritas was given for the collection of data.Results:The sample consisted of 250 subjects (144 Italian and 106 non-Italian). 100 out-patients of the CO and 150 of NPHS. Immigrants made up 81% of the CO sample and 16% in the NPHS sample (p<0.001). Overall, women represented 57% (N=144) of respondents. Patients attending the CO were significantly younger than those at the NPHS (p<0.001). The measures of SES showed significantly lower integration and more unemployment among CO patients, who also lacked information on access to care and more precarious employment, residential (10% homeless) and legal status. Almost all migrant patients had suffered from a dental problemin the last year. Conclusion:Illegal immigrants prefer to access dental care provided by a voluntary organisation as it offers assistance, bypassing bureaucracy. Although access to health care by those who do not comply with the rules on residing in Italy should not require the presentation of documents or be reported to the authorities. Immigrants who use the NPHS are generally more integrated, and have been living in Italy for more than 5 years. Predictably, for immigrants, oral health is a low priority, and this should be regarded as a public health issue.