Abstract
Child oral health conditions, except orthodontic treatments, are fully funded by the New Zealand government. This thesis focuses on publicly funded oral health services provided by the Canterbury region’s Community Oral Health Service (CCOHS) to Pacific children and their families. Child oral health enrolment data (2022-2024) from CCOHS show that enrolled Pacific children have the highest missed-appointment rate compared to non-Pacific and non-Māori children. Out of all the Pacific ethnic groups, missed appointment rates of Tongan children are the highest in the region. The costs of seeing dental professionals have often been cited as a key barrier to accessing dental services. In this case, child oral health services are publicly funded and free to access, yet Pacific families do not appear to take advantage of such opportunities.
This research focuses on Tongan families in the Canterbury region whose children are enrolled in CCOHS but are failing to attend scheduled appointments. Addressing the high rate of missed appointments among Tongan children in Canterbury is an essential goal. However, doing so in a culturally safe and meaningful way contributes to a more permanent solution than a temporary one.
A participatory action research approach was adopted, in which 25 Tongan families worked as co-researchers with the lead researcher to collectively explore insights and strategies for reducing high missed-appointment rates in a culturally safe and meaningful way.
This approach is built on the Tongan practice of collectively planting the yam crop known as the Toutu’u Cooperative Approach (TCA). This practice implies that everyone in the village needs to be on board and work together to improve their overall well-being. Such an approach can be applied to child oral health by sharing technical oral health messages at a level that parents understand and can act on to improve their children's oral health. The CCOHS may need to review their current model of care and reorganise their service offering to ensure they are best positioned to deliver services that actively promote good oral health. Meaningful oral health promotion provides parents with tools to practice dental hygiene, make lifestyle changes in healthy food and drink intake, and attend scheduled dental appointments.
This is the essence of TCA: all stakeholders play a role in improving overall well-being, including child oral health. It is an approach that acknowledges the biomedical approach to oral health as equally necessary as prevention. Parents, non-oral health clinicians, educators, social workers, and the community at large are potential oral health care team members who can champion prevention outside community dental clinics, thereby contributing to improved oral health outcomes for Pacific children and their families.