June 1 marks the first day of LGBTQ+ Pride Month. Equality, inclusion, acceptance, and support for friends and loved ones in the community are critical to the advancement of our society. We talk a lot about these issues during Pride, but the subject of health is often pushed aside. It shouldn’t be. The National Institute on Minority Health and Health Disparities identifies the LGBTQ+ community as a “health disparity population” due to lowered access to health coverage – including dental care. Clinical research shows that sexual and gender minorities who live among high levels of prejudice will die sooner – 12 years on average – than those residing in more accepting environments. Because oral health affects physical and mental health, the issue is too important to discount.
A Growing Community
The number of people in the LGBTQ+ community has risen steadily over the years. According to the most recent Gallup Poll on the topic, published in February 2021, 5.6% of U.S. adults identify as LGBTQ – up from 4.5% in the 2017 survey. Within the ranks of Generation Z (those born between 1997 and 2002), the number climbs to 15.9%. Given these facts, combined with the problem of “health disparity,” providing LGBTQ+ people with access to safe, comfortable, and compassionate oral health care is vital.
LGBTQ+ Dental Issues
Risks Associated with HIV and Hepatitis
Academic research data indicate that bisexual, lesbian, and gay individuals are more likely to rate their oral health unfavorably when compared to their straight peers. Because oral and physical health are intrinsically linked, dentists must be open to discussing concerns beyond oral health to support the needs of this patient group.
Although LGBT people experience higher rates of HIV and hepatitis, these diseases do not represent the singular causes of health risks for the population. They persist, however, as serious risk factors. HIV lowers the body’s immune system and ability to fight infection, which includes infections in the mouth or gums. Some HIV medications also produce side effects that lead to oral health problems.
Substance Abuse and Homelessness
As a result of systemic discrimination and disadvantage, LGBTQ+ people often succumb to higher rates of homelessness and substance abuse than the general population. These circumstances make routine oral hygiene challenging, with dental avoidance leading to tooth decay and other dental complications. For transgender people undergoing hormone therapy, there are additional risks of osteoporosis, changes in bone density, and gum disease.
LGBTQ+ people experience unique hurdles and different stresses than other underrepresented groups, which can contribute to poor mental health. What patients may not realize is the impact of mental health challenges on dental care. For example, people living with anxiety or depression are less likely to maintain a regular oral hygiene regimen. They’re also less prone to scheduling routine dental checkups and cleanings. In certain cases, mental health issues can result in eating disorders, which propel the onset of dental problems.
Facing ongoing and widespread discrimination, LGBTQ+ are naturally reluctant to divulge their gender identities or orientations openly, but this lack of transparency complicates treatment. Failing to disclose relevant health conditions, medications, hormone therapy, and even lifestyle behaviors will likely jeopardize favorable treatment outcomes.
Dental teams must know and understand their patients’ medical histories along with any medications they are taking. This includes medicines prescribed by physicians for HIV or Hormone Replacement Therapy. If a patient has HIV or hepatitis, the dentist must also know about that. Openness is critical to good results and effective treatment.
Dentists are dedicated to improving your oral health, not judging your life or identity. That said, finding a dentist that instills comfort, ease, a sense of security, and trust is imperative. LGBTQ+ people should do their research, seek referrals from other members in the community, and schedule consultations to find a dentist whom they consider ideally situated to care for their unique needs. And with that, we would like to offer a very special case study to demonstrate our commitment to the LGBTQ+ community.
New Smile, New Beginning
Damon Fassett, a courageous young man, was referred to the Blende Dental Group by Western Dental for treatment beyond their dentists’ skill sets.
Damon endured a difficult childhood, underscored by bullying and ostracization. As a transgender male, his early adult years were equally frightening. He developed bulimia and anorexia, causing dental decay, pain, and abscess.
For Damon, who never felt a real sense of belonging or self-confidence growing up, correcting the issues with his teeth and having a beautiful smile became important aspects of his transition to a new life, where he could finally embrace his genuine identity. But the importance of restoring his oral health extended far beyond cosmetics. In order to secure approval for his gender affirmation surgery, he needed to gain back enough weight to undergo testosterone treatment. His oral health complications made eating difficult.
The level of treatment involved would typically require long hours and multiple visits. Dr. Blende accomplished all aspects of his treatment in two sessions. Damon was first seen at Sutter Hospital where he underwent general anesthesia, allowing our team to comfortably and safely complete his dental work. His second visit included the cementations of crowns and bridges in the office using nitrous sedation.
Because of the costly procedure, Damon had initially feared that he wouldn’t be able to move forward with the treatment. Given Damon’s unique and sympathetic circumstances, Dr. Blende’s team performed the procedure at no cost. Damon’s gratitude for the exceptional care and generosity of Dr. Blende brought him to tears. He described Dr. Blende’s attitude and approach as “inspiring.”
Damon has since focused the next stage of his journey on helping others in need by training service animals to assist people suffering from emotional, behavioral, and physical distress. He credited Dr. Blende as a primary impetus for encouraging him to realize his dream.