TL;DR: A cross-sectional study published online in Community Dentistry and Oral Epidemiology on October 13, 2026 compared the social and cultural determinants of oral health among Indigenous pregnant women in Canada, New Zealand and Australia. First Nations and Métis expectant women in Canada were less likely to rate their oral health as fair or poor, twice as likely to have seen a dentist in the past year, and least likely to report cost as a barrier. The authors point to differences in how Indigenous oral health care is governed, funded and delivered.
A new study co-authored by a University of Toronto researcher puts Canada side by side with New Zealand and Australia, using the same survey, adapted for each culture, with Indigenous pregnant women in all three countries. As of October 2026, it offers Canadian dental professionals a direct comparison of how pregnant First Nations, Métis, Māori and Aboriginal women rate their oral health, use dental care and experience the social conditions around it.
For dental professionals in Ontario, including practices in Toronto, Brampton, Scarborough and across the GTA that see Indigenous patients, the findings show how access, cost and experiences of racism differ across Indigenous populations, and the authors link these differences to oral health.
Who Conducted the Study?
The paper, "Cultural and Social Determinants of Indigenous Peoples' Health: Understanding Oral Health Inequities in Canada, New Zealand/Aotearoa, and Australia," was written by H.P. Lawrence, J.R. Broughton and L.M. Jamieson. Their listed affiliations are:
- Dental Public Health, Indigenous Oral Health Research Group, Faculty of Dentistry, University of Toronto (Lawrence)
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand (Broughton)
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide (Jamieson)
It appeared online in Community Dentistry and Oral Epidemiology on October 13, 2026.
How Was the Study Designed?
The researchers used data from the Baby Teeth Talk Study, which the authors describe as a multi-national academic-community partnership. The same survey instrument, with cultural adaptations, was used in each country. Participants were Indigenous pregnant women:
- Canada: 544
- New Zealand: 222
- Australia: 446
The team assessed self-rated oral health and the impact of oral health on dimensions of quality of life. They compared means with z-tests and proportions with the normal approximation to the binomial distribution, adjusting for multiple pairwise comparisons.
An Indigenous framework: the Tree Metaphor
The authors applied an Indigenous framework to a social determinants of health model: Charlotte Loppie's Tree Metaphor. It groups determinants into stem, core and root layers, and the authors describe determinants such as discrimination and racism as more distal and deeply rooted.
What Did the Study Find?
The participants' mean age did not differ significantly across the three countries. Key differences included self-rated oral health, access to care and experiences of racism.
Self-rated oral health
The share of women rating their own oral health as "fair" or "poor" was significantly higher in New Zealand (57.7%) and Australia (54.3%) than in Canada (39.0%).
Access, cost and racism in Canada
First Nations and Métis expectant women in Canada were twice as likely to have visited a dentist in the last year and the least likely to report cost as a barrier to care. They also reported experiencing less racism.
Strengths in New Zealand, challenges in Australia
Pregnant Māori women had higher oral health literacy, greater knowledge of children's oral hygiene and greater oral health self-efficacy. Employment income and social support were also greatest among Māori women. Aboriginal women in Australia faced more unfavourable social determinants, particularly those related to socio-economic status.
Culture as identity
One in three First Nations, Māori and Aboriginal women perceived culture and ethnicity as central to their identity.
Why Do the Countries Differ?
The authors conclude that differences in governance, funding and delivery models for Indigenous oral health care can explain the disparities in access to dental care for pregnant Indigenous women. They add that unique historical and cultural trajectories may account for differences in the more distal, deeply rooted determinants, such as discrimination and racism. Understanding how these socio-cultural determinants differ, they argue, may help explain why some interventions are more effective than others in improving Indigenous Peoples' oral health.
The abstract does not name specific Canadian programs. For context, one federal program that provides dental benefits to eligible First Nations and Inuit is the Non-Insured Health Benefits (NIHB) program run by Indigenous Services Canada. According to Indigenous Services Canada, NIHB dental benefits are for eligible First Nations and Inuit and apply when a benefit is not available through other sources such as provincial or territorial health insurance or private plans. The covered categories it lists include diagnostic, preventive, restorative, endodontic, periodontal, removable prosthodontic, oral surgery, orthodontic and adjunctive services. Indigenous Services Canada directs people looking for the Canadian Dental Care Plan (CDCP) to a different page.
Pro Tip: If your front desk is unsure whether a First Nations or Inuit patient's care should be billed to NIHB, a private plan or the CDCP, check Indigenous Services Canada's NIHB dental pages and its Dental Benefits Guide before the appointment, not at checkout. Billing confusion is an avoidable barrier.
What Can Ontario Dental Practices Take From This?
The study is about population-level determinants, not chairside technique. Still, several practical points follow for practices in Toronto, North York, Mississauga and the wider GTA.
Pregnancy is an access window
The study population was pregnant women, and its measures included knowledge of children's oral hygiene and oral health self-efficacy. Prenatal visits are a chance to support both the parent's oral health and the family's habits before a baby's first tooth arrives.
Cost is not the only barrier
The Tree Metaphor places racism at the root and cultural identity at the core. In our view, a practice can remove a cost barrier and still lose patients who do not feel respected. Culturally safe communication, unhurried explanations and an intake process that does not make assumptions all count.
Pro Tip: Review your intake forms and front-desk scripts once a year with a simple question: would any wording make an Indigenous patient feel singled out or judged? Small language changes cost nothing and can change whether a patient returns.
Different groups, different needs
The authors note that understanding how determinants differ among diverse Indigenous populations may help explain why some interventions work better than others. Our practical takeaway: First Nations, Inuit and Métis patients are distinct groups, and their coverage can differ too, since NIHB dental benefits are for eligible First Nations and Inuit.
Sources
- Lawrence HP, Broughton JR, Jamieson LM. "Cultural and Social Determinants of Indigenous Peoples' Health: Understanding Oral Health Inequities in Canada, New Zealand/Aotearoa, and Australia." Community Dentistry and Oral Epidemiology, published online October 13, 2026. doi:10.1111/cdoe.70128 (PMID 42866967; record via Europe PMC)
- Indigenous Services Canada. Dental benefits for First Nations and Inuit (Non-Insured Health Benefits program).
Frequently Asked Questions
Q: How does Indigenous oral health in Canada compare with New Zealand and Australia?
In a 2026 study of Indigenous pregnant women, 39.0% in Canada rated their oral health as fair or poor, compared with 57.7% in New Zealand and 54.3% in Australia. First Nations and Métis expectant women in Canada were also twice as likely to have seen a dentist in the past year and least likely to report cost as a barrier.
Q: What is the Baby Teeth Talk Study?
The authors describe the Baby Teeth Talk Study as a multi-national academic-community partnership. Its data, collected with the same survey instrument adapted for each culture, were used to compare 544 Indigenous pregnant women in Canada, 222 in New Zealand and 446 in Australia.
Q: Does NIHB cover dental care for First Nations and Inuit?
Yes, for eligible clients. Indigenous Services Canada says the Non-Insured Health Benefits program provides dental benefits for eligible First Nations and Inuit when the benefit is not available through other sources, such as provincial or territorial insurance or private plans.
EBIKO Dental will continue monitoring Canadian oral health research and policy that affects access to care. For more Canadian dental news, visit EBIKO Dental.