The Oral Health and Well-Being Experiences of Indigenous South Australians: A Qualitative Study.

Abstract

To explore the perceptions of Indigenous South Australian adults regarding their oral and general health, social and emotional well-being and dental care experiences. Qualitative study; interviews with Indigenous South Australian adults involved in a non-randomised implementation and service-delivery project evaluating provision of culturally safe, comprehensive dental care. Study governance was provided by an Indigenous Oral Health Unit Reference Group with Indigenous leadership to centre cultural authority and cultural safety across all study dimensions. Semi-structured interviews were conducted with 136 Indigenous South Australian participants at a location of their choosing (e.g., their home, a community centre, a research facility), which were held at baseline (1 July 2022-15 December 2023) and 12-month follow-up (1 March 2024-31 March 2025). The overarching study consisted of a pre-post assessment of oral health embedded in routine dental care with oral epidemiological examinations and assessment of systemic health biomarkers (blood glucose, inflammation, cholesterol, kidney function). This was followed by semi-structured interviews at 12-month follow-up. Qualitative outcomes-participant experiences, understandings and recommendations around supporting oral health, social and emotional well-being and culturally safe dental care for Indigenous South Australians. Reflexive thematic analysis was used to analyse interview data, from which five themes were developed. Participants described the importance of oral health for overall health, aesthetic and functional impacts and judgement and discrimination related to poor oral health, all of which were linked to social and emotional well-being. Culturally safe care that includes oral health assessments alongside assessments of biomarkers for systemic health were suggested to promote self-confidence, reduce feelings of shame and empower communities. This study highlights the need to incorporate holistic approaches in promoting Indigenous oral and systemic health and in supporting social and emotional well-being. Australian New Zealand Clinical Trials Registry (ACTRN12626000046303; retrospectively registered).