Dental News - Study examines dental hesitancy in culturally and linguistically diverse mothers in Australia

Jeremy Booth, Dental Tribune International

Fri. 16. December 2022

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SYDNEY, Australia: Evidence indicates that culturally and linguistically diverse (CALD) communities experience unequal access to oral healthcare services, a fact that raises particular concerns in Australia, where 2021 census data shows that 28% of the population were born overseas and 23% spoke a language other than English. Researchers from the University of Sydney and from Flinders University in Adelaide examined the phenomenon of dental hesitancy among CALD mothers in the country and found that they face several barriers to accessing oral healthcare services.

The qualitative study examined the oral healthcare-related attitudes and experiences of CALD mothers as well as the barriers that they face when accessing dental services. CALD mothers were defined as those who identified as non-English speaking, were born outside of Australia and had a child under 12 years of age.

Corresponding author Kanchan Marcus, a researcher at the University of Sydney School of Dentistry and mixed methods researcher at the university’s Menzies Centre for Health Policy and Economics, explained to Dental Tribune International (DTI) that the study revealed five “C” factors that contributed to dental hesitancy among CALD mothers and resulted in the delay or avoidance of utilising dental services. These were cost, confidence in quality care, confusion in the system, competing priorities and complacency.

Cost was the foremost cause for concern, and CALD mothers reported that dental care in Australia was too expensive. Confusion related to the healthcare system was also a leading factor. Marcus explained: “The Australian public–private healthcare system is overly complex. New migrants have varied levels of language and literacy and sociocultural practices that are distinct to the home country. CALD mothers questioned whether a referral for the dentist was needed, questioned whether there were specialty dentists who had, for example, expertise in diabetes and often reported a minimum wait of four to six months for private dentists rated as ‘good’.”

Marcus said that competing priorities and a sense of complacency contributed to the phenomenon of dental hesitancy among CALD mothers. This is particularly owing to family and societal pressures. “Juggling children, family and household needs and the associated processes of starting a new life in a new country took priority,” Marcus explained, adding that CALD mothers in the sample group repeatedly described the Australian lifestyle as “busy”.

“Mothers are influential for children and family oral health behaviours” — Kanchan Marcus, the University of Sydney

Having identified the factors that often prevent CALD mothers from accessing oral healthcare services and contribute to dental hesitancy, conversely, the study authors suggest that the results offer a blueprint for addressing dental hesitancy in the sample group. For example, Marcus told DTI that cost factors could be addressed with universal health coverage and that simplified, accessible information about the public–private healthcare system in community languages would help to enhance confidence in care and reduce confusion.

Dental professionals could also help to improve the provision of care to CALD mothers on an individual basis. “Mothers are influential for children and family oral health behaviours. A family appointment with a child and mother is one possible solution to supporting CALD mothers, whereas flexibility in appointments to allow after-hours and weekend appointments was suggested,” Marcus said.

According to Marcus, much work is needed from policymakers in order to make access to dental care more equitable. “The federal government should include dental care in Medicare. The New South Wales Government should extend the public provision of dental care to include CALD mothers, which would promote preventive care in the primary sector and reduce the number of emergency presentations for dental conditions at public hospitals,” she said.

The study, titled “Dental hesitancy: A qualitative study of culturally and linguistically diverse mothers”, was published in BMC Public Health on 28 November 2022.