Dental Services Access and Oral Health Improvement in Gypsy, Romany and Traveller Communities: A Scoping Review

Background
Gypsy, Romany, and Traveller (GRT) populations experience poor oral health, with a recognised unmet need for care compounded by multiple barriers to accessing dental services. This scoping review aims to identify and map the available evidence, as well as gaps in the literature, relating to oral health improvement and access to care among GRT populations in Europe.

Methods
Studies published in English relating to oral health improvement and/or access to care among GRT populations were included. Electronic databases searched comprised Embase (Ovid), Scopus (Elsevier), Web of Science (Clarivate), and Dentistry and Oral Sciences Source (EBSCOhost). In addition, a grey literature search was conducted. Titles and abstracts were screened against the eligibility criteria, followed by full-text screening, by two independent reviewers. Included studies were analysed using thematic analysis, and findings were tabulated to illustrate study characteristics and outcomes related to oral health improvement and access to care.

Results
Of the initial 436 search results, 18 publications met the inclusion criteria and were included in the review. Overall, there was a paucity of literature addressing oral health access and improvement among GRT populations, with even fewer evaluated programmes designed to address these challenges. Identified barrier-related themes included limited health literacy, structural barriers to accessing care, prohibitive costs, and population mobility, which affected continuity of care, routine engagement with services, and registration. Fewer facilitating factors were identified. Community health workers were most frequently reported as supporting access to services and promoting oral health within these populations. Interventions such as mobile dental units appeared effective but were resource-intensive. The most sustained benefits in GRT communities were associated with initiatives that fostered trust between communities, health services, and care providers.

Conclusions
GRT communities experience significant disadvantage in accessing dental care, with substantial barriers to meeting their treatment needs. To address the limited evidence base for oral health programmes, further research, particularly focused on oral health improvement, should be conducted with these populations.