Oral health inequalities among indigenous and nonindigenous children in the Northern Territory of Australia

Abstract

Objective: To describe oral health inequalities among indigenous and nonindigenous children in the Northern Territory of Australia using an area-based measure of socioeconomic status (SES). Methods: Data were obtained from indigenous and nonindigenous 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 socioeconomic relationships with dental disease experience. Results: Some 12,584 children were examined, 35.1% 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 nonindigenous counterparts. Indigenous children aged 5 years had almost four times the dmft of their nonindigenous counterparts in the same disadvantage category (P < 0.05), while indigenous children aged 10 years had almost five times the DMFT of similarly disadvantaged nonindigenous children (P < 0.05). A distinct social gradient was apparent among indigenous and nonindigenous 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 nonindigenous 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.