Racial discrimination in oral health care impacts Indigenous lives and livelihoods just as much as other symptoms of institutional racism.
Brooke Fryer

16 May 2019 - 7:40 AM  UPDATED 16 May 2019 - 7:40 AM

Lung conditions, mouth cancers and diabetes can all stem from poor oral health and according to a 2017 report by the Australian Health Ministers and Advisory Council, Aboriginal Torres Strait Islander peoples are the most disadvantaged group when it comes to oral hygiene.

The report also reveals Indigenous people are more likely to be hospitalised for dental diseases and are less likely to "have received preventative dental care" as opposed to non-Indigenous Australians.

Aboriginal liaison officer at the Royal Dental Hospital, Carleen Miller, a Taungurung Elder from central Victoria, said she has seen the lack of education first hand in remote areas when it comes to understanding the importance of keeping up oral hygiene. 

“There’s a lot of barriers in accessing services… places are expecting people to drive up to hours to get a health check,” she said.

Ms Miller said more could be done so regional community members “understand … what needs to be done to maintain good oral health and how that’s connected to overall health and wellbeing.” 

She said unfluoridated water in many regional and remote areas contributes to poor oral health, leading to Aboriginal people who live regionally and remotely being at far greater risk of having poor oral health than Indigenous people living in metropolitan areas.

A survey included in the Federal Government's Aboriginal Oral Health Plan 2014-2020, says Indigenous people are twice as likely to have untreated tooth decay, resulting in loss of teeth and further health issues, including chronic diseases. 

Indigenous children aged four through 15-years-old experience more than three times the decay than non-Indigenous children in these age groups.

These high rates are still prevalent in young adults with Aboriginal people aged 17-20-years-old having 3.2 times the amount of tooth decay and 2.5 times more missing teeth than non-Indigenous people.

More than 50 per cent of Indigenous adults and older people have had at least one tooth removed compared to the 25 per cent of non-Indigenous adults.

The statistics have caught the attention of both major parties leading into Saturday's election.

The federal Coalition government has pledged $70 million to providing free dental services for NSW primary school students if re-elected.

The initiative will see over 136,000 students benefit from mobile dental services over the next four years. 

Bill Shorten's Labor party promises to commit $2.4 billion towards a Pensioner Dental Plan if they win. Labor's plan will provide free dental services to all Australians over the age of 65.

The plan will also deliver $1,000 every two years –via Medicare – to those receiving the Age Pension benefit, or who have a Commonwealth Seniors Health Card, including Indigenous people. 

Former ACT MP and first known Aboriginal dentist, Dr Chris Bourke, a Gamilaroi man, told NITV News if there is no specific initiative to help Indigenous children then it is never “going to deliver the kind of outcomes you’d want for Indigenous kids”. 

In effect over the last four years, there has been the Child Dental Benefits Schedule that is eligible to any child between the ages 2-17 who is on Medicare. 

But programs that are not designed in conjunction with Aboriginal and Torres Strait Islander people usually don't give good outcomes in Aboriginal health, said Dr Bourke. And this has a compounding effect on the issue of promoting good oral health in community.

He said oral health in young children is extremely important, he said, as it teaches Indigenous kids good habits early on which assists in preventing future diseases in adulthood. But Dr Bourke said Indigenous patients – of all ages– can be treated in a manner that dissuades them from wanting to return to the dentist.

The problems may even extend to dentists not valuing the wishes of their Indigenous patients.

"More often than not dentists assume their Indigenous patients would rather have teeth removed than to find a solution," said Dr Bourke. “Basically they’re taking their beliefs … and then bringing them into clinical situations.” 

“You don’t impose your stereotypes and your values on the interaction with the patient in front of you.” 

Dr Gari Watson, a Gurang Gurang, Biri Gubba and Gangulu man, who has been practising privately at Morayfield in Moreton Bay for two years, said Aboriginal people have “stayed away from the dentist because they have been judged in the past”.

“That has contributed a lot to people not accessing dental services,” he said.

Dr Watson said institutional racism in the dental health system; much like the health system more broadly, is also a key issue that needs addressing.

“I’ve been discriminated in a way that I may not necessarily be a good dentist … just purely on the basis that I am Aboriginal,” he said.

'Doomed to failure': Close the Gap peak bodies call for election funding promise
NACCHO CEO Pat Turner says at least $5bn and a commitment to work with communities is needed to get anywhere in Closing the Gap.
Lawyers for Aunty Tanya Day make submission of 'Systemic Racism'
If the submission is accepted by the Coroner it will be a landmark decision as the examination of systemic racism has not been included in the full scope of an Australian Coronial inquest previously.
Racism from nurses and GPs hindering treatment, VACCHO says
A new survey reveals Indigenous people in Victoria experience high levels of racism when seeking medical care.