Indigenous Oral Health
Oral health is concerned not just with teeth, but can be defined as ‘a standard of health of the oral and related tissues that enables an individual to eat, speak, and socialise without active disease, discomfort, or embarrassment, and that contributes to general wellbeing'.
Photo courtesy of Remote Area Health Corps
The ramifications of poor oral health can be immense, and there are marked oral health disparities between Indigenous and non-Indigenous Australians. Oral diseases, including dental caries and periodontal diseases, are among the most prevalent diseases in the community. Their consequences result in dental problems being consistently ranked amongst the most frequently reported illness episodes by Australians, and their treatment costs constitute a large part of the $A2.6 billion spent on dental services each year. This figure increases by a factor of ten when the Indigenous Australian population is considered in isolation.
Good oral health is an essential component of being healthy overall. The mouth is a portal for entry and a mirror of general health, and the body of evidence linking oral health to other conditions only continues to grow. Unsurprisingly, tooth loss will often restrict eating and can thereby result in weaker nutritional intake - it can be associated with anaemia and gastrointestinal disturbances. More complex relationships link oral infection to systemic disease, for example diabetes.
In Australia, Indigenous people have more caries, periodontal disease, and tooth loss than other Australians and, given that problems are more likely to go untreated, are also more likely to have teeth removed. Dental caries and periodontal disease can have significant effects on eating, sleep and rest, and social roles. There are many factors impeding the availability of dental care for the Indigenous community, amongst them physical access to services for rural and remote communities, cultural appropriateness of treatment, education on the maintenance of healthy teeth and nutrition, and financial restrictions.
Many oral health problems suffered by Indigenous Australians share risk factor characteristics with wider general health problems. This means that while a great deal of work needs to be done, we can choose to see this as an opportunity to create positive change - efforts to encourage healthy eating, for example, are likely to have a positive impact not just on the oral health of the community but could also lead to reduced incidence of heart disease, obesity, and anaemia. An oral health campaign around links with drinking alcohol and smoking could have ramifications not just on oral health, but rates of oral cancer. Such associations mean that the potential benefits of improvements in Indigenous oral health could extend to have numerous other health benefits, and as we learn more about these links our capacity to improve the situation will only increase. Improved information and understanding of oral health and dental care for this group is absolutely essential for the development and implementation of informed, effective public health policy.