Aspirations and Worries: The Role of Parental Intrinsic Motivation in Establishing Oral Health Practices for Indigenous Children.

Brianna F Poirier,Lisa M Jamieson,Joanne Hedges,Megan Moskos,Lisa G Smithers

doi:10.3390/ijerph182111695

Abstract

Aboriginal and Torres Strait Islander (respectfully, subsequently referred to as Indigenous) children in Australia experience oral disease at a higher rate than non-Indigenous children. A history of colonisation, government-enforced assimilation, racism, and cultural annihilation has had profound impacts on Indigenous health, reflected in oral health inequities sustained by Indigenous communities. Motivational interviewing was one of four components utilised in this project, which aimed to identify factors related to the increased occurrence of early childhood caries in Indigenous children. This qualitative analysis represents motivational interviews with 226 participants and explores parents’ motivations for establishing oral health and nutrition practices for their children. Findings suggest that parental aspirations and worries underscored motivations to establish oral health and nutrition behaviours for children in this project. Within aspirations, parents desired for children to ‘keep their teeth’ and avoid false teeth, have a positive appearance, and preserve self-esteem. Parental worries related to child pain, negative appearance, sugar consumption, poor community oral health and rotten teeth. A discussion of findings results in the following recommendations: (1) consideration of the whole self, including mental health, in future oral health programming and research; (2) implementation of community-wide oral health programming, beyond parent-child dyads; and (3) prioritisation of community knowledge and traditions in oral health programming.

Highlights

Dentistry was originally established as a surgical specialty, with generations of dentists trained in highly invasive, operatively based treatments, grounded in biomedical theories of disease at the individual level [1,2,3]
The wider research project aimed to ascertain the impact of Motivational Interviewing (MI) on parental oral health behaviours; this paper aims to explore intrinsic motivations identified by parents of Indigenous children during motivational interviews, which can be employed to enhance effectiveness of future oral health prevention efforts
The findings presented in this paper are derived from the MI component of a randomised controlled trial of an Early Childhood Caries (ECC) intervention

Summary

Introduction

Dentistry was originally established as a surgical specialty, with generations of dentists trained in highly invasive, operatively based treatments, grounded in biomedical theories of disease at the individual level [1,2,3]. The futility of this biomedical approach, which largely ignores social determinants of health, has been critiqued over the past century [4,5]. As a public health approach to dentistry, values prevention and attempts to tackle foundational causes of oral disease, upstream determinants and structural drivers of inequity [1].

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Conclusion