Oral Health of Aboriginal People

A particularly high prevalence of poor oral health and early childhood caries (ECC) is evident in Australian Aboriginal communities when compared with non-Aborignal children in the same age cohorts, which has had severe implications for Aboriginal children. Evidence suggests that poor childhood oral health is not only a strong predictor of poor adult oral health, but also has various impacts on the health and wellbeing of the child, including growth and development. More research exploring the oral health practices of Aboriginal children aged 0-5 years in NSW is required to identify suitable strategies to improve oral health in the early years.

The Gudaga study explores the oral hygiene, feeding and dietary practices of young children from an urban aboriginal community in south-western Sydney, Australia, and the Bulundidi Gudaga study compares these practices with oral health assessment data.

Funding is gratefully acknowledged from:

• NSW Centre for Oral Health Strategy

Project team:

• Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

• Prof Maree Johnson – Australian Catholic University, Ingham Institute

• Clinical Associate Prof Sameer Bhole – SLHD Oral health services, Sydney Dental Hospital, University of Sydney

• Dr Shilpi Ajwani – SLHD Oral health services, Sydney Dental Hospital, University of Sydney

• Sharon Ellis – Campbelltown Hospital SWSLHD

• Prof Anthony Blinkhorn – University of Sydney

• Assoc Prof Elizabeth Comino – University of New South Wales Centre for Primary Health Care and Equity

• Dr Lynn Kemp – Western Sydney University, Ingham Institute

• Dr Jennifer Knight – University of New South Wales Centre for Primary Health Care and Equity

• Dr Rebekah Grace – Macquarie University

The Aboriginal and Torres Strait Islander people of Australia experience inequality in health status across the lifespan compared to their non-Indigenous counterparts. Although there have been some improvements in health outcomes, the gap is still significant. An area where Indigenous people have poorer health outcomes in Australia is in maternal and infant health. Infants who are born to Australian Aboriginal and Torres Strait Islander mothers are more likely to be pre-term and of low birth weight compared to their non-Indigenous counterparts. Further, Indigenous children are twice as likely to develop early childhood caries in both deciduous and permanent teeth compared to other children. Early childhood caries is the most common chronic childhood disease worldwide and affects various aspects of the child’s functioning.

Although typically overlooked, a common risk factor in all these health outcomes is maternal oral health. Maternal dental decay can contribute to early childhood caries especially if mothers engage in certain feeding practices after birth like sharing the same spoon which can result in bacteria transmission to the child. In light of the importance of maternal oral health, it is now recommended that all pregnant women consult a dentist early during pregnancy and be provided oral health education, risk assessment and referral during antenatal care. However, Indigenous mothers are less likely to attend their first antenatal visit until later in the pregnancy and tend to underutilise preventive health services, such as dental services. Aboriginal Health Workers (AHWs) are in an excellent position to fill this gap as they currently play a key role in accessing and advocating for Indigenous Australians, and bridging the gap with the healthcare system. They are often responsible for leading culturally-appropriate health promotion and educational activities within primary health care. Although some studies have explored the potential for AHWs to disseminate oral health education, a recent scoping review (under review, led by the PhD candidate) showed that their role in promoting maternal oral health has received little attention.

The aim of this study is to develop a culturally-appropriate model of care focussed on capacity building of Aboriginal health workers to promote oral health among Indigenous pregnant women and their children. This research will occur in three phases:

Phase 1: Exploring perceptions of AHWs and Indigenous pregnant women towards oral health care

Phase 2: Developing the model of care for Indigenous pregnant women

Phase 3: Pilot testing the model of care with AHWs

Project team:

• Ariana Villarosa – Western Sydney University, SWSLHD, Ingham Institute

• Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

• Dr Lucie Ramjan – Western Sydney University, Ingham Institute

• Dr Mariana S. Sousa – Western Sydney University, SWSLHD, Ingham Institute