Indigenous Australians and Oral Health

Indigenous disadvantage is an ongoing problem in Australia. In terms of health, the situation is critical. Indigenous Australians 1 experience higher rates of chronic disease, the persistence of serious ear and eye infections amongst young children, and often poor access to primary health care facilities (Aboriginal and Torres Strait Islander Social Justice Commissioner, 2005). In the area of oral health, there is also a wide disparity between Indigenous and non-Indigenous Australians. Unfortunately available data on the oral health of Indigenous people is limited, making it all the more difficult to make progress towards eliminating this discrepancy. The reasons for the gap are many, but include the fact that culturally appropriate and timely dental care are often inaccessible, as are appropriate resources on how to maintain good oral health, particularly for those residing in rural and remote areas. Differing understandings of health, as well as the division between medicine and dentistry that has traditionally been so strong in Australia, do nothing to help the situation. Reducing the disparities in oral health between Indigenous and non-Indigenous groups is an immense task that will require a dedicated and coordinated approach – it will depend on improved access to dental care as well as a more holistic approach to oral health, including preventive measures. In the past, Indigenous Australians enjoyed better oral health than non-Indigenous people Harford et al., 2003). Dental decay and periodontal disease were uncommon in rural and remote Indigenous communities up until recently. Caries was, throughout the 19th and early 20th centuries, regarded as a disease of affluence in Australia – but has now become an ‘indicator of deprivation’ (Williams et al., 2011). As foods rich in fermentable carbohydrates became more common in rural and remote areas, so did dental decay (Harford et al., 2003). While oral health risk factors are the same for all Australians, many Indigenous people do not enjoy the same access to protection from dental decay afforded by fluoridated water, toothpaste, or easy access to dental care. This chapter will begin with an overview of the general situation of Indigenous health and disadvantage in Australia, including a discussion of the Close the Gap campaign, and will also delve briefly into Indigenous understandings of health to provide some cultural context. We will then move on specifically to the topic of oral health amongst the