Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia.
Umoona Tjutagku Health Service, Coober Pedy 5723, Australia.
Int J Environ Res Public Health. 2023 Feb 8;20(4):2955. doi: 10.3390/ijerph20042955.
Indigenous South Australians carry a disproportionate burden of dental diseases, with approximately 80 percent of Indigenous adults having both periodontal disease and dental caries. The chronic inflammatory nature of many dental conditions means there are widespread systemic impacts, particularly on type 2 diabetes, chronic kidney disease and cardiovascular disease. Evidence suggests there are barriers experienced by Indigenous South Australians in accessing timely and culturally safe dental care. This study aims to: (1) elicit the views of Indigenous South Australians regarding their perspectives of what comprises culturally safe dental care; (2) provide such dental care and; (3) assess any changes in both oral and general health using point-of-care testing following receipt of timely, comprehensive and culturally safe dental care.
METHODS/DESIGN: This mixed-methods study will involve qualitative interviews and an intervention without randomisation. The qualitative component will comprise seeking perspectives of Indigenous South Australians regarding what culturally safe dental care means for them. For the intervention component, participants will take part in oral epidemiological examinations at baseline and 12-month follow-up (after receipt of dental care), which will include collection of saliva, plaque and calculus, as well as completion of a self-report questionnaire. The primary outcome measures-changes in type 2 diabetes (HbA1c), cardiovascular disease (CRP) and chronic kidney disease (ACR)-will be obtained by blood/urine spot from a finger prick/urine collection at baseline and 12-month follow-up via point-of-care testing.
Participant recruitment will commence in July 2022. The first results are expected to be submitted for publication one year after recruitment begins.
The project will have a number of important outcomes, including increased understanding of what culturally safe dental care means for Indigenous South Australians, the delivery of such care, and empirical evidence of how culturally safe dental care leads to better prognosis for chronic diseases linked with poor oral health. This will be important for health services planning, especially in the Aboriginal Community Controlled Health Organisation sector, where the management of dental diseases in a culturally safe manner for better chronic disease outcomes is currently insufficiently understood, planned and budgeted for.
澳大利亚南部的土著居民患有牙齿疾病的比例过高，大约 80%的土著成年人同时患有牙周病和龋齿。许多牙齿疾病具有慢性炎症性质，这意味着它们会对全身产生广泛的影响，特别是对 2 型糖尿病、慢性肾脏病和心血管疾病。有证据表明，澳大利亚南部的土著居民在获得及时和文化安全的牙科护理方面存在障碍。本研究旨在：（1）了解澳大利亚南部土著居民对文化安全牙科护理的看法；（2）提供这种牙科护理；（3）使用即时、全面和文化安全的牙科护理后，通过即时检测评估口腔和整体健康状况的任何变化。
方法/设计：本混合方法研究将包括定性访谈和非随机干预。定性部分将包括寻求澳大利亚南部土著居民对文化安全牙科护理对他们意味着什么的看法。对于干预部分，参与者将在基线和 12 个月随访（接受牙科护理后）进行口腔流行病学检查，其中包括收集唾液、牙菌斑和牙石，以及完成自我报告问卷。主要结局指标-2 型糖尿病（HbA1c）、心血管疾病（CRP）和慢性肾脏病（ACR）的变化-将通过即时检测从手指刺血/尿液收集的血液/尿液点在基线和 12 个月随访时获得。
参与者招募将于 2022 年 7 月开始。预计第一个结果将在招募开始一年后提交发表。
该项目将产生许多重要结果，包括更好地了解文化安全的牙科护理对澳大利亚南部土著居民的意义、提供这种护理以及文化安全的牙科护理如何导致与口腔健康不良相关的慢性疾病预后更好的实证证据。这对于卫生服务规划非常重要，特别是在原住民社区控制的健康组织部门，目前对以文化安全的方式管理牙齿疾病以获得更好的慢性疾病结果的理解、规划和预算不足。
