Future nurse/midwife

Isap Case Study Refugee Children
Professional Issues
Background
As a future nurse/midwife, you will play an important role in the provision of holistic
health care. Dental/oral health is fundamental to overall health, wellbeing and quality of
life. Yet, many barriers exist to achieving good dental/oral health for socio-cultural,
behavioural and environmental reasons with myriad consequences for affected people
and the health care system.
To prepare your Student Response, please choose one of the vulnerable population
groups listed below and then discuss dental/oral health care in relation to your chosen
group based on each of the questions below.
Vulnerable population groups – choose one as the focus of your assessment task:
Indigenous children
refugee children
homeless children
Student Response
In preparing your Student Response, please ensure that you address the following:
Define dental/oral health, and briefly describe three consequences of poor dental/oral
health for children.
Critically analyse the poster in relation to your chosen population group and briefly
discuss three possible barriers to implementing the suggested dental hygiene practices.
Briefly discuss the resources needed to improve dental/oral health for your chosen
population group.
Critically examine Healthy Mouths, Healthy Lives: Australia’s National Oral Health
Plan 2015 – 2024 (see Resources page for link) for the inclusion of your chosen
population group, and based on your suggestions (in Q2 and Q3) identify any gaps that
exist in the recommendations.

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Briefly outline the responsibility of the nurse/midwife in dental/oral health
promotion/care and list three other professional groups you would collaborate with to
improve dental/oral in your chosen population.

Background (~270 words)
Define dental/oral health, and briefly describe three consequences of poor dental/oral
health for children.
Oral health is a state of well-being defined by the state of the mouth, associated tissues,
which enables an individual to chew, communicate verbally, comfortably or
embarrassment (Sanchez, Everett, Salamonson, Ajwani, Bhole, Bishop, & Sheehan, 2017).
Tooth decay is one of the consequences of poor dental health among the children. In
Australia, approximately more than a third of children in early childhood present with the
decay of teeth at any given time of their childhood (World Health Organization, 2015).
Generally, individuals from high socio-economic class can afford the cost of preventive
and treatment services offered as part of health care services. Nutrition characterized by
food with high sugar content predisposes children to the development of dental health
conditions such as tooth decay (Gomes, Sarmento, Costa, Martins, Garcia, & Paiva, 2014).
The cost of fast foods is cheaper than the cost of nutrient intensive foods. Individuals from
low socioeconomic class can afford foods with high contents of sugar, exposing the
children to tooth decay. Children affected by dental health conditions experience pain a
result of exposure and subsequent stimulation of pain receptors in the teeth’s cavity. Pain
causes discomfort to the affected child. Subsequently, affected children cannot participate
comfortably in schoolwork; entertainment activities and social interactions are interfered

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with (Kumar, Kroon, & Lalloo, 2014). Poor dental health negatively affects the chewing
function of teeth. Affected children have thus the difficulty in feeding. The eventual effect
is impaired nutritional intake. Additional consequences of poor dental health are
pneumonia and cardiac conditions (Kumar, Kroon, & Lalloo, 2014).

Assessment (~270 words)
Critically analyse the poster about your chosen population group and briefly discuss three
possible barriers to implementing the suggested dental hygiene practices?
Refugee families are one of the disadvantaged groups in Australia. According to the
Australia Bureau of Statistics, 23 % of the Australian population comprises a low
economic class of citizens. Research studies state that refugee children are seven times
more likely to be diagnosed with dental health conditions compared to children from high
socio-economic class (Riggs, Gibbs, Kilpatrick, Gussy, Gemert, Ali, & Waters, 2015).
Refugee children are likely to sustain untreated dental health conditions. The rate of
attendance of the general population to dental health services has increased over recent
decades. However, the accessibility of oral health services by children from the low socio-
economic class has not been noted to improve. In Australia, oral health care is one of the
healthcare services that are majorly financed through direct out of pocket payment.
Refugees in Australia mostly are categorized among the low social, economic populations
(Finnegan, Rainchuso, Jenkins, Kierce, & Rothman, 2016). Refugee families are socially
isolated since they represent some of the culturally minor groups in Australia. Therefore,
children from refugee families have limited access to dental health care in Australia. Sugar
intensive foods are generally cheaper than other nutrient-rich foods. Since refugee families
mostly represent the low socio-economic class, such families take foods rich in sugar

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intensive foods. Refugee children, together with their families, live in poor
neighbourhoods, with general low hygiene standards, including oral health. Poor oral
health predisposes the refugee children to oral infections, tooth cavities, and decay (Riggs,
Rajan, Casey, & Kilpatrick, 2017).

Resources (~270 words)
Briefly discuss the resources needed to improve dental/oral health for your chosen
population group.
To improve dental health care for refugee children, risk assessment of the development of
dental health conditions among the refugee population is one of the requirements. There
are established frequencies for seeking dental health services across all the age groups
across the lifespan. Additional data from research is required to establish the frequency of
seeking dental health care for specific groups of population, including refugee children.
The guidelines on the frequency of dental health clinic visits for refugee children should be
based on the accessibility of dental health care and availability of resources to afford the
costs of dental healthcare services in Australia (Nicol, Al-Hanbali, King, Smith, &
Cherian, 2014).
Transport is required to facilitate accessibility to oral health care services for refugee
children. Most of the refugee population lives in the poor neighbourhood settlement in
urban and suburban areas, due to low social, economic status. Dental health facilities
should be built in areas accessible to the refugee population within the public transport
system and with parking facilities (Wright, Aldhalimi, Lumley, Jamil, Pole, Arnetz, &
Arnetz, 2016).
Expansion of Child Dental Benefits Schedule (CDBS) to children from special and

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prioritized populations such as refugees is a requirement to improve dental health services
to refugee children. The program provides dental health care for children aged between two
and seventeen years of age at subsidized costs. The program is applicable for children in
both private and public health care systems in Australia. The inclusion of refugee children
in the subsidized program for treatment of dental health conditions reduces health disparity
between children from high socio-economic class, therefore, improving dental health care
for children from the refugee population group (Tonmukayakul, Sia, Gold, Hegde, Silva,
Moodie, & Sia, 2015).
Financial resources to fund awareness creation are another type of resource required to
improve oral health care to refugee children. The refugee population should be educated
about the availability of available dental health services in Australia. The government
should create awareness among members of the general public on programs such as Child
Dental Benefits Schedule that facility accessibility to dental health care by refugee children
in Australia (Wright et al., 2016).

Policy (~270 words)
Critically examine Australia’s National Oral Health Plan 2015 – 2024: Healthy Mouths
Healthy for gaps, if any that exist about your chosen population group.
One of the critical areas not addressed by the report is consumer involvement of the
refugee involvement. Patient-centred care is essential to improve oral health care. In order
to achieve patient satisfaction, it is crucial to address the concerns of the refugee
population. The refugee children individually face by unique social and economic
challenges about dental health (Piovesan, Antunes, Guedes, & Ardenghi, 2013). Economic

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and social characteristics of a population determine the healthcare condition of every
patient population. Economic characteristics include the specific ability of individuals to
purchase healthcare services. The social support system and family structures affect the
level healthcare condition of refugee children population (Urden & Dineen, 2015).
Also, the report does not address the ethical and legal issues surrounding access to dental
health care for the refugee population in Australia. Refugee populations are comprised of
the diverse patient population from all over parts of the world. Some refugee families have
diverse beliefs about the management of dental health conditions. For example, various
cultural backgrounds provide diversified explanations of the aetiologies of dental health
conditions. Similarly, diverse cultural backgrounds determine the treatment approaches and
attitudes towards the occurrence of dental health conditions. Dental healthcare
management should consider the ethical and cultural diversity among the priority groups of
the population. Refugee background includes the type of food commonly used by the
affected population group. The paper, also, does not address the legal framework that
determines the access to oral health care. The legal framework, states the rights, privileges,
and limitations of the rights of refugees about social services and the legal responsibility of
dental health service providers (Urden & Dineen, 2015).

Action Plan (~270 words)
Briefly outline the responsibility of the nurse/midwife in dental/oral health promotion/care
and list, three other professional groups; you would collaborate with to improve dental/oral
in your chosen population.
Nurses have several roles in oral health care. Firstly, nurses are responsible for identifying

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populations that are at high risk of developing dental health conditions. Nurses are
responsible for carrying out community oral health programs to screen members of the
society for risk factors of developing dental health. According to the data acquired on the
exposure of members of the particular population to dental health conditions, nurses carry
out preventive measures against dental health conditions (Group, 2015). Nurses have a role
in advocating for equality and reduction in oral healthcare disparities between various
dominant and minority groups within the Australian dental health system. Nurses come
into contact with the dental health patient routinely during their practice and thus
understand the issues surrounding dental healthcare. Nurses should participate in policy
formulation to promote equality care and an increase in dental health care by
disadvantaged and minority groups in Australia (Willis, Reynolds, & Keleher, 2016).
Nurses are responsible for creating collaboration with social workers in the provisions of
the community based dental health care. Dental health should be integrated into other
social work services such as housing, nutritional care, and social welfare. Also, nurses
should partner with nutritionists in preventing occurrence dental health care services.
Nutrition plays a significant role as an etiology for several common dental health
conditions such as tooth decay. Nurses should also collaborate with refugee welfare
organizations and bodies to identify the background socio-economic and cultural
information, which is relevant in dental health care. Social-economic and cultural
characteristics of populations determine stability to afford dental healthcare (Jin, Lamster,
Greenspan, Pitts, Scully, & Warnakulasuriya, 2016).

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References

Finnegan, D. A., Rainchuso, L., Jenkins, S., Kierce, E., & Rothman, A. (2016). Immigrant
caregivers of young children: Oral health beliefs, attitudes, and early childhood caries
knowledge. Journal of community health, 41(2), 250-257.
Gomes, M. C., de Almeida Pinto-Sarmento, T. C., de Brito Costa, E. M. M., Martins, C. C.,
Granville-Garcia, A. F., & Paiva, S. M. (2014). Impact of oral health conditions on

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the quality of life of preschool children and their families: a cross-sectional study.
Health and quality of life outcomes, 12(1), 55.
Group, O. H. (2015). AUSTRALIA’S NATIONAL ORAL HEALTH PLAN 2015 – 2024.
Adelaide: Oral Health Monitoring Group.
Jin, L. J., Lamster, I. B., Greenspan, J. S., Pitts, N. B., Scully, C., & Warnakulasuriya, S.
(2016). Global burden of oral diseases: emerging concepts, management and interplay
with systemic health. Oral diseases, 22(7), 609-619.
Kumar, S., Kroon, J., & Lalloo, R. (2014). A systematic review of the impact of parental
socio-economic status and home environment characteristics on children’s oral health
related quality of life. Health and quality of life outcomes, 12(1), 1.
Nicol, P., Al-Hanbali, A., King, N., Slack-Smith, L., & Cherian, S. (2014). Informing a
culturally appropriate approach to oral health and dental care for pre-school refugee
children: a community participatory study. BMC Oral Health, 14(1), 69.
Piovesan, C., Antunes, J. L. F., Guedes, R. S., & Ardenghi, T. M. (2013). Impact of
socioeconomic and clinical factors on child oral health-related quality of life
(COHRQoL). Quality of life research, 19(9), 1359-1366.
Riggs, E., Gibbs, L., Kilpatrick, N., Gussy, M., van Gemert, C., Ali, S., & Waters, E. (2015).
Breaking down the barriers: a qualitative study to understand child oral health in
refugee and migrant communities in Australia. Ethnicity & health, 20(3), 241-257.
Riggs, E., Rajan, S., Casey, S., & Kilpatrick, N. (2017). Refugee child oral health. Oral
diseases, 23(3), 292-299.
Sanchez, P., Everett, B., Salamonson, Y., Ajwani, S., Bhole, S., Bishop, J., … & Sheehan, M.
(2017). Perceptions of cardiac care providers towards oral health promotion in
Australia. Collegian.

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Tonmukayakul, U., Sia, K. L., Gold, L., Hegde, S., de Silva, A. M., Moodie, M., & Sia, K. L.
(2015). Economic Models of Preventive Dentistry for Australian Children and
Adolescents: A Systematic Review. Oral health & preventive dentistry, 13(6).
Urden, L. D., & Dineen, K. K. (2015). Ethical and Legal Issues. Priorities in Critical Care
Nursing-E-Book, 10.
Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health
care system. Elsevier Health Sciences.
World Health Organization. (2015). Guideline: sugars intake for adults and children. World
Health Organization.
Wright, A. M., Aldhalimi, A., Lumley, M. A., Jamil, H., Pole, N., Arnetz, J. E., & Arnetz, B.
B. (2016). Determinants of resource needs and utilization among refugees over time.
Social psychiatry and psychiatric epidemiology, 51(4), 539-549.

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