Author: Zahra Shahriyari Afshar
Despite access to general dental services provided by dentists, hygienists and other dental care workers employed by the First Nations and Inuit Health Branch (FNIHB), many Indigenous families face various adversities when attempting to use dental services. Lawrence et al.'s (2009) paper Oral health inequalities between young Aboriginal and non-Aboriginal children living in Ontario, Canada reports on the oral health measures of Indigenous children residing in various areas (off and on reserves) of Ontario, Canada. These findings are then compared to the findings of non-Indigenous Children living in the same locales. Dental hygienists conducted oral examinations using standard dental equipment, and researchers collected cross-sectional oral health data to illustrate differences between the children's oral hygiene. It is seen that many indigenous families living off-reserve have more difficulties "finding a dentist, claiming benefits and navigating the healthcare system “than those living on-reserves” (Lawrence, 2009). Subsequently, off-reserve Indigenous families had less support and resources and had approximately 2 to 3 times the risk of untreated decayed teeth (Lawrence, 2009).
Based on the results, the mean DMFT scores (Decayed, Missing due to caries, and Filled Teeth in the permanent teeth) were more significant for Indigenous children than their non-Indigenous classmates across all health statuses measures (Lawrence, 2009). This shows the disparities between Indigenous and non-Indigenous children in Canada.
Furthermore, inequalities were also observed regarding early childhood caries (ECC) between off-reserve Indigenous and non-indigenous children, as Indigenous children "were nearly three times more likely to have untreated caries, and two times more likely to have debris on the labial surfaces of the central primary incisors" than their non-indigenous classmates. It may be that the disproportionate dental health and general health inequalities among Indigenous and non-indigenous youth attending the same school could be a symptom of cultural differences, however, barriers set by society due to inequities of stable housing, education and better employment opportunities can also be indirectly associated with colonization and racism and can be another reason as to the inaccessibility to better dental health care.
Overall, healthcare quality and accessibility in Canada continue to fall behind for Indigenous communities. Implementing more programs to resolve the social and cultural determinants of oral health inequalities can aid in the betterment of health care services for Indigenous families' lives and can help alleviate some of the burdens many families face both on and off reserves.
Reference:
Lawrence, H. P., Binguis, D., Douglas, J., McKeown, L., Switzer, B., Figueiredo, R., & Reade, M. (2009). Oral health inequalities between young aboriginal and non-aboriginal children living in ontario, canada. Community Dentistry and Oral Epidemiology, 37(6), 495-508. https://doi.org/10.1111/j.1600-0528.2009.00497.x