While tooth decay is theoretically preventable, Aboriginal Australians suffer worse dental caries and gum disease than other Australians yet progress is slow to reduce such disparities. This presentation draws on qualitative research to identify Aboriginal people’s perspectives on how to improve oral health.
Interviews and group discussions were conducted, where possible by an Aboriginal and non-Aboriginal researcher, with 107 Aboriginal participants–35 health workers, 50 parents/carers and 22 teenagers across 18 sites in Perth, WA. Responses were analysed for key themes reflecting barriers and enablers to improving oral health.
Overall findings showed that oral health was important yet often compromised by factors beyond individual control. These included lack of education about preventing oral disease from pregnancy onwards, intense marketing of sugary products, cost of services and discrimination from health providers; many participants felt judged on the state of their oral health. While teenagers knew what caused tooth decay, such as sugar in food and drinks, knowledge was often not linked to practice.
Enablers to oral health included respectful and welcoming dental services for Aboriginal people, oral health education and promotion from pregnancy to all sectors of the community, flexible public services for 0-4 year olds and including oral health in general health checks.
As socioeconomic factors can negatively impact on making optimum decisions about oral health, current policies and models of care need critical review for their effectiveness in reducing inequalities in oral health between Aboriginal and non-Aboriginal Australians. This calls into question the prevailing discourse that often places Aboriginal people at the centre of the problem. An alternative discourse is needed where Aboriginal and non-Aboriginal stakeholders work together to design and implement policies and practices that acknowledge and address broader socioeconomic factors, are respectful of Aboriginal people, well-resourced and translate into sustained improvements to their oral health.