Abstract
Deafness exists on a spectrum, encompassing individuals with varying degrees of hearing loss. Culturally Deaf refers to people within this spectrum who identify as members of the Deaf community and share a distinct language, New Zealand Sign Language (NZSL), as well as unique values and cultural identity, rather than viewing deafness as a disability. Culturally Deaf individuals experience persistent barriers to equitable healthcare, including oral health care, yet their lived experiences remain underrepresented in research, particularly in New Zealand.
This study aimed to explore the lived dental care experiences of culturally Deaf adults across the country, with a focus on communication, cultural, and systemic challenges. Semi-structured interviews with 21 participants from nine regions, representing a wide age range, were analysed using reflexive thematic analysis following Braun and Clarke’s approach. Seven themes were identified. Participants reported communication barriers, including reliance on lipreading and limited use of visual aids. Limited access to NZSL interpreters was particularly problematic for NZSL-first users, while affordability strongly influenced access to timely and appropriate care.
Trust and self-advocacy were described as emotionally demanding, with participants emphasising that trust developed through mutual patience and openness. Community advocacy highlighted Deaf-led initiatives to improve oral health knowledge and understanding. Practitioner cultural competence was considered essential, with inclusive care beginning with recognising and valuing Deaf culture and communication preferences. Participants also noted the sensory impact of the dental environment, including heightened awareness of environmental stimuli and background noise.
These findings suggest that communication is both the primary barrier and the key opportunity for improving dental care. While current communication gaps hinder accessibility and trust, they also represent a critical point for positive change. Enhancing visual, language-accessible, and culturally responsive communication could improve accessibility, responsiveness, and quality of care. The resilience and self-advocacy demonstrated by many Deaf individuals provide a foundation for building genuine and effective partnerships with dental professionals.