Insights into the complexity of navigating dental care for Aboriginal and Torres Strait Islander people with kidney failure

Abstract Background A synergistic relationship exists between oral disease and kidney disease. Patients diagnosed with kidney failure often face significant challenges in accessing and maintaining dental care while undergoing dialysis. Consequently, many are compelled to have all their teeth extracted prior to being considered eligible for a renal transplant. This study aimed to provide culturally safe dental support for Aboriginal and/or Torres Strait Islander People on dialysis in South Australia and to report on the oral health impact, socio-demographics, social and emotional wellbeing, and general health of this cohort. Methods This mixed-methods study recruited Aboriginal and/or Torres Strait Islander People with kidney failure from three rural and one metropolitan site in South Australia. Data collected included questionnaires, focusing on socio-demographics, self-reported general and oral health, quality of life measures; an interview focusing on the oral health story; and a dental clinical examination. Dental support was provided for all participants, and dental journeys were followed up for a year after recruitment. Results A total of 36 Aboriginal and/or Torres Strait Islander adults diagnosed with kidney failure, aged 34 to 78 years (mean = 57.38 ± 11.05) were recruited. More than 50% of participants reported having seen a dentist at least once since starting dialysis, and just over 60% reported that poor oral health currently made them ineligible for being allocated to the renal transplant list. By the end of 12 months, 57% of the total participants had attained a dental clearance, which enabled them to be considered for renal transplantation waitlisting and, two successfully received a renal transplant by study completion. Conclusion This study highlights the burden of oral disease for Aboriginal and/or Torres Strait Islander People undergoing renal dialysis and provides evidence to inform a change in dental service delivery.