Table 1 Characteristics of included programs on integrated primary oral health care in Indigenous communities
Author, year and country | Type of program | Program strategy | Oral health care provision |
|---|---|---|---|
Bain and Goldthorpe, 1972, Canada [46] | University of Toronto’s Sioux Lookout Project | • Collaborative services for Cree and Ojibway people in Sioux Lookout region involving multidisciplinary health services including dental services | • Development of dental clinic at one nursing station • Basic dental facilities in all nursing stations and some satellites • Dental care provided by dentists and interns • Development of caries prevention program Outcomes: Program was found to be feasible after 3 years. |
Chiarchiaro G, 1997, USA [47] | Indian Health Service in Oklahoma | • Oklahoma dental program as part of integrated health care system | • Clinic-based dental services and community-based oral health promotive and preventive services • Population based program such as for school children, people with special needs • Multidisciplinary team working with cleft palate team |
Lawrence HP, 2004, Canada [48] | Community-based dental-hygiene coordinated Prenatal Nutrition Program | • Community-based dental preventive program for Early childhood caries at Sioux Lookout Zone performed by Woman and Child Community Nutrition Program workers • Cross-sectional survey was conducted among 2 to 5-year old Anishnaabe children from 16 communities where 8–8 communities were identified as high-low intervention communities based on frequency and coverage of health worker and participants contact | • Trained health workers provided culturally sensitive nutrition and dental preventive education to pregnant women, new mothers, and elders raising children during home visits • Promotion of healthy food, optimal oral hygiene practices via head start brushing • Reinforcement of healthy dental care practices by nurses during Well Child Clinics • Offered oral educational packages to caregivers • Media campaigns and distribution of posters and pamphlets • Smoking cessation sessions Outcomes: • Overall positive outcomes • Improved hygiene and reduced number of decayed surfaces • Improved oral health knowledge and preventive practices of caregivers and less untreated carious teeth significantly higher among the high-intervention communities • But still higher demand for dental services under GA |
Parker EJ et al., 2005, Australia [49] | Oral health program by Pika Wiya Health Service Inc. | • Implementation of the first phase of the program in 2001 to develop culturally relevant quality oral health care services | • Provision of dental services for eligible adults 2 days per week • Oral health promotion at schools’ festivals and Pika Wiya health service open days. • Referral for patient transport services to radiology department and local pharmacy Outcomes: • Program was successful • More satisfied community members |
Harrison RL et al., 2006, Canada [50] | Brighter Smiles | • This participatory research program aimed to improve children’s oral health in a Hartley Bay First Nations community by providing service-learning experience to paediatric residents | • Oral health care provision via classroom teachings, school-based brushing, fluoride application, and regular visits by UBC paediatric residents for well-child care. Outcomes: • Service-learning experience was successful • More preventive treatments were offered compared to restorative or rehabilitative treatments |
Kruger et al., 2010, Australia [51] | Case study | • To discuss 10 years experiences of Centre for Rural and Remote Oral Health in Western Australia | • Oral health services via developing vertically integrated service, education and research driven model • Co-location • Provision of Fly-in and fly-out services • Symbiotic relationship among health and dental care providers that creates a supporting environment • Interprofessional collaboration • Culturally relevant services by involving IHW • Interprofessional education |
Meihubers S, 2013, Australia [52] | Bila Muuji Oral Health Promotion Partnership Program | • Bila Muuji Aboriginal Health Service initiated this program involving primary care workers at Aboriginal Community Controlled Health Organisations • Target groups: children less than 5 years, school-aged children, young adults, people with chronic disease, and the elderly | • Appointment of oral health promotion coordinator • Oral health promotion programs including school-based daily toothbrushing, oral health information sessions; training primary care staff. Outcomes: • Continuing • Positively accepted by the community • Improved oral health profiles |
Mathu-Muju KR, 2016, Canada [54] | Children’s Oral Health Initiative (COHI) – Community-based preventive program for First Nations and Inuit children | • Its short-term aim was increase access to preventive oral health care services and long-term outcome to decrease levels of dental disease. • Conducted by Dental hygienists and therapists under Health Canada for Aboriginal communities and COHI aide (trained community health workers) • Target groups: preschool children, school children, parents/primary caregivers, and pregnant women | • Preventive oral health care services included fluoride varnish, pit and fissure sealants, oral health counselling and atraumatic restorative therapy. • COHI aide helps in explaining program purpose to parents and obtains inform consent, oral health education, schedule dental appointment as well as fluoride varnish application. Outcomes: • Program has been successful • It extended to 320 communities over a period of 10 years from 2004 to 2014 along with increase in number of participating children. |
Wooley S, 2016, Australia [65] | Nganampa Health Council Dental Program | • Commenced in 1986 to provide accessible, appropriate and effective oral health | • Oral health care via 2 dental operatories at health clinics, mobile dental units (dental truck) and portable dental equipments • Oral health services included promotive services, emergency Service, school dental program, adult dental program, special needs, and prosthodontics. Outcomes: • 100% rate of sealants and varnishes in children. • More dental caries in children at 6 years, lesser DMFT in 12 years children and more restorative unmet needs, diabetes associated periodontal diseases and edentulousness in adults, • Still challenges were existing and necessitates further coordination and referral programs. |
Maari Ma Health Aboriginal Corporation, 2016, Australia [66] | Evaluation of Maari Ma Health Aboriginal Corporation’s Chronic Disease Strategy | • Integration of oral health into health programs ‘Healthy start’ and ‘Keeping well program’ • ‘Clean Teeth Wicked Smiles’ oral health promotion program for school-aged children • ‘Tiddilicks’ program for pre-school children promoting tooth brushing and drinking water rather than fizzy drinks • Incorporation of oral health into health screening, fluoride varnish and fissure sealants application • Fluoride varnish application as part of GP’s child health checks • ‘Filling the Gap program’: volunteer dentists visit for 1–2 week period | • Promotion and prevention of oral health via public health dentist, dental therapist and Indigenous dental assistants • Treatment done by dentist Outcomes: • ‘Clean Teeth Wicked Smiles’- significant increase in the number of children brushing twice or more a day • Significant reduction in decayed primary and permanent teeth in children |
Cree Board of Health and Social Services of James Bay, 2004, Canada [67] | Cree Board of Health and Social Services of James Bay developed the Strategic Regional Plan 2004–2014 | • Implemented an integrated delivery of health and social services in the Cree communities including integration of oral health into primary care | • CBHSSJB has developed a separate dental clinic in each Community Wellness Centre in all communities • Provision of free services by dentists and dental hygienists • Preventive oral health programs carried out by various dental and non-dental healthcare providers |
Torres and Cape Hospital and Health Service, 2018, Australia [68] | The Torres Strait Primary Oral Health Care Project 2017–2019 | • Aimed to develop oral health roles for remote primary health providers by integrating oral health assessments and first response duties within remote Primary Health Care Centres via telehealth technologies | • Use of videoconferencing by the dental team at Thursday Island hospital to train and support health care providers at rural and remote primary health care centres in their oral health activities as well to facilitate communication and clinical consultations among them Outcomes: • Program’s implementation phase resulted in improved oral health assessment and promotion by primary care providers |
Ontario’s Aboriginal Health Access Centres [69] | Waasegiizhig Nanaandawe’iyewigamig | • Provision of comprehensive primary health care services to its first nations communities including travelling health care providers to remote areas | • Health promoters with dental hygienist include offer promotive and preventive oral health services including via COHI |
Ts’ewulhtun health centre annual report 2017–18 [72] | Ts’ewulhtun health centre, BC, Canada | • Offer primary health services to Cowichan tribes | • Co-located dental clinic • Offer oral health education, prevention and restorative treatment to all community members including COHI • Oral health promotion within public health programs |
Sts’ailes primary health care project: report, 2013 [25] | Nisga’a Valley Health Authority (New Aiyansh, BC) | • Offers primary health services to Nisga’a communities | • Co-located dental clinic |
Sts’ailes primary health care project: report, 2013 [25] | Anishnawbe Health (Toronto, ON) | • Offers primary Health Care Services by a multidisciplinary team, including dentist | • Offers promotive, preventive and clinical dental services • Delivers Healthy Smiles Ontario Program |
Alaska Native and American Indian people in the Anchorage Service Unit area | • Integrated primary health care model with wide range of health services including dental services | • All types of dental services | |
Indian health services [71] | Federal health services to American Indians and Alaska Natives | • Integrated dental services with other health care services | • Ranges from basic and prevention services to all dental treatments |