Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada.
Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.
Int J Equity Health. 2021 Jun 7;20(1):134. doi: 10.1186/s12939-021-01476-5.
Inequities in early childhood oral health are evident amongst Indigenous peoples and communities in Manitoba, Canada. Early childhood caries (ECC) is decay in primary dentition in children under 6 years of age. A severe form of the disease occurs at a higher rate in Indigenous populations compared to the general population. ECC has been strongly associated with social determinants of health.
Focus groups and sharing circles were conducted with four First Nations and Metis communities in urban and rural communities in Manitoba. There were eight groups in total of purposively sampled participants (n = 59). A grounded theory approach guided thematic analysis of audio recorded and transcribed data.
Indigenous participants experienced challenges similar to those found in the general population, such as encouraging and motivating parents and caregivers to establish regular oral hygiene routines for their children. However other challenges reported, disproportionately affect Indigenous communities. These include poor access to dental care, specifically no dental offices within 1 h driving radius and not having transportation to get there. Not having evidence-based oral health information to support good oral hygiene practices, preventing parents from making the best choices of oral hygiene products and oral health behaviours for their children. Poverty and food insecurity resulting in poor nutritional choices and leading to ECC. For example, feeding children sugary foods and beverages because those are more readily avialble than healthy options. Confusing or difficult encounters with dental professionals, highlighted as a factor that can erode trust, reduce compliance and impact continued attendance at dental offices.
Closing existing early childhood oral health gaps for First Nations and Metis peoples and communities requires equity-oriented healthcare approaches to address specific problems and challenges faced by these populations. Family, community and systemic level interventions that directly implement community recommendations are needed.
在加拿大马尼托巴省，原住民和社区在儿童口腔健康方面存在明显的不平等现象。幼儿龋病（ECC）是指 6 岁以下儿童的乳牙发生龋坏。与一般人群相比，这种疾病的严重形式在原住民群体中更为常见。ECC 与健康的社会决定因素密切相关。
在马尼托巴省城乡的四个第一民族和梅蒂斯社区进行了焦点小组和分享圈活动。共有八个小组，参与者是经过有针对性抽样的（n=59）。一个扎根理论方法指导了对录音和转录数据的主题分析。
原住民参与者经历了与一般人群相似的挑战，例如鼓励和激励父母和照顾者为孩子建立定期的口腔卫生习惯。然而，其他报告的挑战对原住民社区的影响更大。这些挑战包括难以获得牙科保健服务，特别是在 1 小时车程范围内没有牙科诊所，也没有交通工具去那里。缺乏循证口腔健康信息来支持良好的口腔卫生习惯，使父母无法为孩子选择最佳的口腔卫生产品和口腔健康行为。贫困和粮食不安全导致营养选择不佳，从而导致 ECC。例如，给孩子喂食含糖食物和饮料，因为这些食物比健康食品更容易获得。与牙科专业人员的困惑或困难的接触，被认为是一个可能破坏信任、降低合规性并影响继续到牙科诊所就诊的因素。
为第一民族和梅蒂斯人民和社区缩小儿童口腔健康方面的现有差距，需要采取以公平为导向的医疗保健方法，以解决这些人群面临的具体问题和挑战。需要采取家庭、社区和系统层面的干预措施，直接实施社区建议。
