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Smile: Community-led research supports better oral health in Indigenous community

Updated: Jun 23, 2023

By Ashleigh Mattern for SHRF

Former mayor of La Loche, Robert St. Pierre has had firsthand experiences with the challenges his community faces when it comes to accessing dental care. He worked at the elementary school when his children were young, and he approached the School Board about providing dental care coverage for employees.

La Loche, image credit: Tourism Saskatchewan

“I knew teeth were important and I knew they had crooked teeth … and I knew they needed orthodontic work,” he said.

His request went through, and between himself and his wife, who also worked at the school, they had 100 per cent coverage for dental care — but that support still didn’t cover travel.

The Village of La Loche in northern Saskatchewan is a 3.5 to six hour drive to the nearest dentist, and that’s only one of the challenges the community has when it comes to accessing dental care.

The village was recently involved in research funded by the Saskatchewan Health Research Foundation that was designed to look at the oral health needs of Indigenous communities while engaging the community in the research.

St. Pierre had his children’s dental care covered, but that was only the first hurdle to cross. If the roads were bad or there was an illness in the family, an appointment might get postponed. And sometimes that appointment ends up just being the first of many to address the issue.

His family was lucky with two parents employed at the school, but not everyone in the area has those opportunities. He noted that there isn’t a strong economy in the area, which can be yet another hurdle to taking care of teeth.

“For a lot of families, teeth and healthy teeth are not important for them because they’re just trying to figure out where they’re going to sleep next or where their next food comes from,” he said. “Good teeth become a backburner. Taking care of oral health is not a priority — getting fed is.”

The interdisciplinary, community-led research doesn’t focus on how to fix these challenges. Instead, the team looked at the strengths of the community and how these could be used to support better oral health.

The expertise of every member on the research team contributed to building a sustainable relationship, enhancing the health and well-being of children and families, and highlighting the impact of the research in presentations and publications.

Practical applications for children’s oral health

One result of the research is a book titled Smile, designed to share with community members how best to care for their teeth.

The idea for the book came from the community members themselves, and they were highly involved in the creation of the book, including providing photographs of community members demonstrating good oral health practices. The book is written in both English and Dene, and there’s an audiobook version available in Dene as well.

Smile highlights key points from the research that would help to decrease early childhood cavities like how to check for cavities, and teaching children how to brush their teeth at least twice a day and having someone supervise them until they’re capable enough to do it on their own.

Cover of "A Smile"

Lead researcher Marcella Ogenchuk, associate professor at the University of Saskatchewan College of Nursing, said the team wanted to show that community members could be a grand-parent, kokum, parent, or Elder with all of their teeth.

“There’s a kokum with her grandchild smiling at the end so you can see that they both have healthy teeth,” Ogenchuk said. “Not all people realize that if you take care of your teeth, you can have them for the rest of your life.”

The book can be viewed online through the University of Saskatchewan: A Smile

Respectful research

Both the book and the research wouldn’t have been possible without the full engagement of the community.

Martha Morin

As participatory research, members of the community were involved from the beginning, including Martha Morin, who was an Administrative Assistant and the Wellness Coordinator at the high school when she first started working with Ogenchuk.

Morin helped find people to participate in the oral health surveys and helped find translators for the Dene versions of the book, among other support.

“Marcella has been a very good advocate for health in our community,” Morin said. “She’s a very supportive and caring person and that goes a long way in our community, which is why I agreed to support her in her initiative. I know her heart is in the right place.”

Today, Morin is working in town administration, but she’s still in touch with Ogenchuk about her work, and she’s strongly in favour of participatory research.

“If you want to do something regarding our community, you need to come into our community and meet people and talk to them. It’s more effective and respectful,” she said.

“People are starting to understand Indigenous people have different cultural practices and you need to take that into consideration when you’re doing research because you may be misinterpreting things.”

Marcella Ogenchuk

Ogenchuk says the support from SHRF not only made this research project possible, but her involvement in the community has led to more research opportunities for the community.

“To fund community-based research and understand the significance of it is so important,” she said. “For me, it has established a research home, a community to work with, and broadened my understanding.”

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