Dental care among Indigenous Australians

The intervention is a course of comprehensive dental treatment delivered in a culturally safe way to Indigenous South Australian adults and children, primarily through Aboriginal Community Controlled Health Organisation (ACCHO) clinics, public, and private dental services. Participants gain access to periodontal therapy via referral into dental care immediately after their baseline oral epidemiological assessment and biospecimen collection, with appointments scheduled according to clinical need, local service capacity and ownership of healthcare card. The frequency and number of visits vary by participant, as treatment is tailored to the severity and distribution of periodontal disease and caries, and may involve multiple sessions for scaling and root planing, extractions, restorations, and prophylaxis with fluoride varnish, all provided free of charge over the course of the 12-month study period leading up to follow-up assessment. The periodontal therapy (scaling and root planing of subgingival plaque and calculus, extraction of unsalvageable teeth, caries removal and restorations, and comprehensive prophylaxis with fluoride varnish) is delivered by registered oral health professionals (e.g. dentists, oral health therapists, hygienists) who receive additional training from dentally qualified study staff experienced in this intervention model. Adherence is supported and monitored through structured treatment planning and documentation in dental records, linkage of completed procedures to the protocol (e.g. documentation of quadrant debridement, completed restorations, extractions, and preventive care), and oversight by the study’s dental investigators. Cultural safety is embedded via Indigenous leadership, mandatory cultural safety training for non-Indigenous staff, ongoing debriefing led by the Senior Indigenous Research Officer, attention to fears such as judgment and ensuring participants feel safe across all points of dental contact (from reception to specialist care). Cultural safety training for non-Indigenous staff is undertaken prior to commencement of participant recruitment and service delivery (as part of study start-up) and is reinforced by regular, structured debriefing and reflection sessions (e.g. monthly) facilitated by the Senior Indigenous Research Officer, rather than as a single one-off workshop. The duration and format of these sessions are designed to provide sufficient time for staff to critically reflect on practice, discuss emerging issues, and adapt behaviours and clinic processes in response to Indigenous community feedback, thereby maintaining fidelity to the culturally safe care model throughout the 12-month intervention period.