Oral health inequalities among Indigenous and non-Indigenous children

Objective: To describe oral health inequalities among Indigenous and non-Indigenous children in the Northern Territory of Australia using an area-based measure of socio-economic status (SES). Methods: Data were obtained from Indigenous and non-Indigenous 4-13-year-old children enrolled in the Northern Territory School Dental Service in 2002-2003. The Socio-Economic Indices For Areas (SEIFA) were used to determine socio-economic relationships with dental disease experience. Results: Some 12,584 children were examined, 35.1 percent of whom were Indigenous. Across all age-groups, socially-disadvantaged Indigenous children experienced higher mean dmft and DMFT levels than their similarly-aged, similarly-disadvantaged non-Indigenous counterparts. Indigenous children aged 5-years had almost four times the dmft of their non-Indigenous counterparts in the same disadvantage category (P<0.05), while Indigenous children aged 10-years had almost five times the DMFT of similarly disadvantaged non-Indigenous children (P<0.05). A distinct social gradient was apparent among Indigenous and non-Indigenous children respectively whereby those with the highest dmft/DMFT levels were in the most disadvantaged SES category and those least disadvantaged had the lowest dmft/DMFT levels. In most age-groups, Indigenous children who were least disadvantaged had worse oral health than the most disadvantaged non-Indigenous children. Conclusions: The findings suggest that Indigenous status and SES have strong oral health outcome correlations but are not mutually dependent, that is, Indigenous status influences oral health outcomes irrespective of social disadvantage. From a health policy perspective, greater oral health gains may be possible by concentrating public health and clinical effort among all Indigenous children irrespective of SES status.