Maori dental care ‘out the window’

Press, 25 January 1988, Page 8

Maori dental care ‘out the window’

By

DESMOND SMITH,

8.D.5., D.D.H.P.

Word of Mouth

Two hundred years ago the Maori had one of the finest physiques in the world and his health was superb. Along with that went a dental health that showed practically no tooth decay and jaw structure that was a joy to behold. Then came our socalled civilisation and its accompanying foods. Dental health started to go out the window amongst the Maoris of the cities, although many of the rural people kept their traditionally healthy mouths. This was especially noticeable amongst those who. lived near the coast and were able to indulge in the sea foods which were so"much a part of their diet in times gone by.

A couple of centuries down the road from those early days, and before we got fluoride in our water and our toothpaste, things became pretty bad; and

the ones who suffered most from dental problems were the young Maoris. It was common to see adults, only 19 or 20 years of age, with no natural teeth left- and sometimes no denture either. But fluoride has turned all that around and teeth are starting to stay where they have always been meant to be — in the gums. Over the last five to 10 years, dentists are once more seeing the beautiful, strong teeth that nature has provided for the Maori people. However, there is still some way to go, because in a national survey a few.

years ago, quite a high percentage of Maoris said that teeth were not worth saving. Worse still, the study showed that the Maori population had a higher rate of extraction and double the filling rate of other adults in the country. Amongst people who care in the medical and dental world there is general agreement on the urgent need for consultation with the Maori people. Up to now there have certainly not been any serious discussions over dental matters.

Maori health lays heavy emphasis on spiritual concepts such as the wairua, and on family associations as expressed in the whanaungatanga and tipuna. There are a number of people who still visit their tohunga, for dental advice. Now Western dentistry has no business just walking roughshod over all of that.

If you add difference in socio-economic levels and the occasional presence of low self-esteem, it is no wonder that dental health comes very low indeed on the list of priorities for many Maori families. Being truly Maori means embracing spiritual and philosophical ideas which are completely unknown to any European health planning. If the large Maori section of our population is to be given a fair deal by the dental profession, there needs to be a marriage of all that is good from both traditions.

No sane person is going to accept regular treatment for dental care un-

less that treatment is done in an environment which is comfortable to them. And just how many dental facilities does the profession make available on the marae, for example? Dentists have been saying for several years that treatment is much more successful if performed with the family group. Nothing could be more pleasing to Maori philosophy and yet we just do not see it happening around us. Far too often the language, attitudes and behaviour of the dental profession form a barrier to the establishment of understanding and cooperation with Maori patients. But things are looking up for the future, starting with the recent Government policy of putting control of Maori health in the hands of the tribal authorities. The Maori Women’s Health Committees all over the country are increasing the awareness of their members about dental health; groups such as the Maori Mormons are developing a very positive stand on the prevention of dental disease; and in the training school for dental nurses more Maori students are being accepted.

Next time we can talk about how all this affects the young Maori mother and preschooler. Meanwhile there is great hope to be found in the words of the Maori proverb: Nau te rourou, naku te rourou, ka ora ai te iwi. (With your basket and my basket we will ensure that the people live.)