Truth & tooth: Co-designing evidence for an anti-racist dental health system in Australia (Preprint)
Authors: Poirier Brianna , Hedges Joanne , Haag Dandara , Paradies Yin , Mackean Tamara , Bastos João , Leane Catherine , Soares Gustavo , Sethi Sneha , Manuela Jessica , Santiago Pedro , Owen Kelli , Bauer Natalie , Milne Jodie , Smith Ashleigh , Smith Kelly , Larkins Priscilla , Cachagee Madison , Garg Vaibhav , Sykora Latisha , Reid Nicolas , Larkin Michael , Fuller Jayde , Jamieson Lisa 
Published: November 2024

BACKGROUND

Racism arrived in Australia with colonisation and its intentionally oppressive policies and actions towards Aboriginal and Torres Strait Islander Peoples. To a large extent, the colonial and biomedical agenda are maintained by Australia’s health system that underlies much of the racialised health inequities in the country. Dentistry significantly lags behind medicine and other health care areas in the uptake of antiracism, with the dental accreditation body only acknowledging racism as a determinant of oral health in 2022.

OBJECTIVE

This project will comprehensively develop the evidence required for an anti-racist dental health system in Australia through co-design of the following objectives: (1) Development of an anti-racist curriculum for dental students; (2) Workforce strategies that support the attraction, retention, and wellbeing of the Aboriginal and Torres Strait Islander dental workforce; and, (3) Oral health promotion training for Aboriginal Health Workers/Practitioners (AHW/P).

METHODS

This project is grounded in decolonising methodologies and Indigenous methodologies, which inform our ways of working at the knowledge interface. Co-design Yarning sessions will inform the development and implementation associated with each of the objectives through tabulation and narrative synthesis of sessions. Objectives will be evaluated with both quantitative and qualitative measures and analysed accordingly with Inverse Probability of Treatment Weighting, content analysis, or reflexive thematic analysis.

RESULTS

The study received ethical review approval in February 2024 and received funding in June 2024. The co-design phase for each objective will run from July 2024 to February 2025. The dental curriculum will be developed in 2025 and delivered to the 2026 student cohort. Evaluation data will be collected from the comparator student cohort in 2025 and the implementation cohort in 2026. Data collection for the development of workforce strategies will be collected from October 2024 to July 2025, the framework will be developed from August to December 2025 and disseminated in 2026. Oral health promotion training will be developed from August to February 2024, implemented from March to June 2025, and qualitative evaluation data will be collected between July to September 2025.

CONCLUSIONS

The proposed research will enhance anti-racism training of non-Indigenous health practitioners, support Aboriginal and/or Torres Strait Islander dental workforce, and improve oral health training for AHW/P. Together, these strategies will build oral health knowledge at the Community level, in turn supporting Aboriginal and Torres Strait Islander self-determination of oral health.