Brush with care: Improving Indigenous oral health

The Melbourne Dental School has embedded Indigenous health education in the Bachelor of Oral Health by offering students the opportunity to learn about the obstacles facing Indigenous Australian communities seeking or receiving care.

The curriculum, developed by Professor Julie Satur in consultation with Professor Shaun Ewen, Associate Dean (Indigenous Development) is designed to equip students with understanding and respect for indigenous people and to develop the skills needed to provide culturally sensitive health care.

Debbie Ha spent three weeks in Arnhem Land contributing to oral health education programs and working in a community clinic as part of an Indigenous health research project in oral health.

"Placement in the Northern Territory was a once-in-a-lifetime opportunity," said Debbie. "The experience made me think more about the consequences of my actions and how my role as an Oral Health Therapist affects beyond the day-to-day patients I see, right into the whole community."

Embedding Indigenous education and health determinants throughout the course provides students with a foundation. This is followed by rotations including with the Rumbalara Aboriginal Health Service, Goulburn Valley Health in Shepparton and placements with Oral Health Services Northern Territory (OHS-NT) in Darwin and remote communities.

Associate Professor Manaka Abuzar with a student

Emma Cubis (Bachelor of Oral Health, 2013) describes her time in the Northern Territory as eye opening. "My time there proved firsthand how the social determinants of health affect oral health and the way services are able to be provided," she said. Isolation and compromised access to nutritious food, dental hygiene products and fluoride toothpaste, expert care and unreliable access to resources, such as water and electricity, all contribute to poorer oral health.

"I think about it often in my daily practice," said Lauren Bylart who spent three weeks in Darwin, Gove and the Tiwi Islands in 2013. It taught me to look at the bigger picture surrounding our patients and their families and not just at the immediate oral environment. There is so much more to patient care than just treating the disease present."

Earlier this year, Shauna McNaughton was the first Indigenous graduate from the new Melbourne Dental School Postgraduate Certificate in Dental Therapy (Advanced Clinical Practice).

Ms McNaughton worked in an Aboriginal Medical Centre in Newcastle as a dental therapist for 10 years until recently. The postgraduate certificate qualified her to provide preventive treatments, check-ups and fillings for a wider range of people. She came to Melbourne for the course with the encouragement of her husband and family. "[The course] allows me to provide dental care for people of all ages rather than just children and adolescents and to give more to my community. It opens up more scope for me in a career that I love," she said.

To assist her relocation to Melbourne during semester, collaboration between the Melbourne Dental School and the Faculty of Medicine, Dentistry and Health Sciences provided for a special scholarship to support her completion of the course.

Having worked in Aboriginal community clinics for a number of years, Ms McNaughton has seen some improvements in oral care.

"I have noticed over the past 10 years I have worked in Indigenous health that some of the messages are getting through and mothers are looking after their children's teeth a little better." But she still thinks there is more to be done.

The Faculty is committed to constant improvement in Indigenous health, and engagement with the community is important in building programs that meet priorities for those communities.

The Melbourne Dental School's Indigenous Oral Health Placement Program received the University's 2015 Award for Excellence in Indigenous Higher Education. "The Indigenous oral health clinical experience is an integral part of the Rural Dental Rotation," said Associate Professor Menaka Abuzar who leads the Indigenous Oral Health Placement Program. "Students contribute to the provision of dental services to the local community including Indigenous community on a continuing basis."

The program runs in collaboration with the Rural Health Academic Centre and Goulburn Valley Health, where non-Indigenous dental students are placed in outreach clinics in the Rumbalara Aboriginal Oral Health Centre as a way of fostering culturally safe clinician-patient relationships and encouraging graduates to provide much-needed oral health care to Indigenous communities.

"Improved cultural awareness among graduates would allow them to work more effectively with Australian Indigenous communities." Two years after their placement in the Northern Territory, the students' experience in visiting the Northern Territory has changed how they work with their patients today.

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This article was originally published in 29 September 2015.