Reducing Indigenous Oral Health Inequalities: A Review from 5 Nations

J Dent Res. 2018 Jul;97(8):869-877. doi: 10.1177/0022034518763605. Epub 2018 Mar 19.

Abstract

Indigenous populations around the world experience a disproportionate burden in terms of oral diseases and conditions. These inequalities are likely due to a complex web of social determinants that includes poverty, historical consequences of colonialism, social exclusion, government policies of assimilation, cultural annihilation, and racism in all its forms (societal, institutional). Despite documented oral health disparities, prevention interventions have been scarce in Indigenous communities. This review describes oral health interventions and their outcomes conducted for Indigenous populations of the United States, Canada, Brazil, Australia, and New Zealand. The review includes research published since 2006 that are available in English in electronic databases, including MEDLINE. A total of 13 studies were included from the United States, Canada, Brazil, and Australia. The studies reviewed provide a wide range of initiatives, including interventions for prevention and treatment of dental disease, as well as interventions that improve oral health knowledge, behaviors, and other psychosocial factors. Overall, 6 studies resulted in improved oral health in the study participants, including improvements in periodontal health, caries reduction, and oral health literacy. Preferred intervention methodologies included community-based research approaches, culturally tailored strategies, and use of community workers to deliver the initiative. Although these studies were conducted with discrete Indigenous populations, investigators reported similar challenges in research implementation. Recommendations for future work in reducing oral health disparities include addressing social determinants of health in various Indigenous populations, training future generations of dental providers in cultural competency, and making Indigenous communities true partners in research.

Keywords: Indigenous people; access to care; community dentistry; dental public health; epidemiology community-based research.

Publication types

  • Review

MeSH terms

  • Australia
  • Brazil
  • Canada
  • Dental Care / organization & administration*
  • Health Services Accessibility
  • Health Services, Indigenous / organization & administration*
  • Health Status Disparities*
  • Humans
  • Indians, North American
  • Indians, South American
  • Mouth Diseases / ethnology*
  • Mouth Diseases / prevention & control*
  • Native Hawaiian or Other Pacific Islander
  • New Zealand
  • Oral Health / ethnology*
  • United States