Factors influencing the perceived importance of oral health within a rural Aboriginal and Torres Strait Islander Community in Australia.

Abstract

Background Indigenous Australians suffer from higher rates of oral disease and have more untreated dental problems and tooth extractions than the general population. Indigenous Australians also have lower rates of accessing oral health services and are more likely to visit for a problem rather than a check-up. Multiple issues effect health service and prevention programs including: characteristics of health services such as distances to health services; existence of social and cultural barriers; available wealth and social support; and, characteristics of the individual and community including the importance given to the disease. This paper seeks to explore the perceived importance of oral health within a rural Indigenous community in Australia and the factors influencing this perception. Methods The study used a phenomenology research design incorporating focus group discussions and in-depth interviews. It was undertaken in partnership with communities’ Health Action Group who guided the focus, implementation and reporting of the research. A convenience sample was recruited from established community groups. Thematic analysis on the transcripts was completed. Results Twenty- seven community members participated in three focus groups and twelve in-depth interviews. The study found that the community gives high priority to oral health. Factors influencing the importance include: the perceived severity of symptoms of oral disease such as pain experienced due to tooth ache; lack of enabling resources such as access to finance and transport; the social impact of oral disease on individuals including impact on their personal appearance and self-esteem; and health beliefs including oral health awareness. Participants also noted that the importance given to oral health within the community competed with the occurrence of multiple health concerns and family responsibilities. Conclusion This paper highlights the high importance this rural Indigenous community gives to oral health. Its findings suggest that under-utilisation of oral health services is influenced by both major barriers faced in accessing oral health services; and the number and severity of competing health and social concerns within the community. The study results confirm the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of rural Indigenous communities.

Caries experience among adults in core Sámi areas of Northern Norway

“…31 The high caries experience among indigenous people when compared to nonindigenous people in Australia, Brazil and New Zealand are related lower education levels, limited access to dental services, and scarcity of dentists and other dental healthcare workers of indigenous ethnicity in areas where indigenous people live. 32,33 These challenges are known to result in inequalities in oral health between indigenous and nonindigenous populations in these countries. Although Sámi people generally have the same access to dental health care as their nonindigenous counterparts in core Sámi areas, 16 there is a history of irregular access to dentists in our study area.…”

Challenges in Oral Health Provision and Utilization in the Australian Indigenous Population: A Scoping Review

“…The second theme identi ed was socio-economic status This theme comprised economic status and social and cultural status of the Indigenous Australian population that poses many challenges in the utilization of oral health services. Financial concerns of the families [23,35], transportation problems [8,29] and living in remote areas [39] were among some of the economic challenges of oral health utilization. Cultural barriers included di culty in communication [36], language barriers [29] and low selfe ciency [34].…”

“…Public health issues in this regard are divided into public health behaviours and public health facilities. The main concept among the Indigenous population according to our ndings include beliefs [8] and perceptions [22] that affect oral health-related behaviours. These behaviours range from daily tooth brushing and uoride toothpaste use to consumption of sugary foods and carbonated beverages [25].…”

“…Australians have a higher rate of dental caries, more untreated teeth, more periodontal problems, lower levels of oral health literacy and lower reported quality of life compared to other people in the community [7][8][9].…”

“…However, access and utilisation of dental public health services among Indigenous Australians remains low [7,16,17]. This has many consequences, with dental problems leading to emotional, physical and nancial impacts [12], as well as feelings of shame about personal appearance and self-esteem [8].…”