Acculturation and its impact on the oral health status of Pacific children in New Zealand: findings from the Pacific Islands Families study.
OBJECTIVE
Immigration and acculturation are increasingly recognized as important explanatory factors for health disparities, although their impact on oral health is less well understood. This study investigates the relationship between Pacific children's cultural orientation and oral health, after adjusting for potentially moderating and confounding variables.


METHODS
The Pacific Islands Families (PIF) study follows a cohort of Pacific infants born in 2000. PIF study participants' data from their last dental examination were extracted from service records, and matched to the cohort. A bi-directional acculturation classification, derived from maternal reports, was related to children's oral health indices in crude and adjusted analyses.


RESULTS
1,376 children were eligible, of whom 922 (67.0 percent) had mothers born outside New Zealand. Matching was successful for 970 (70.5 percent) children, with mean age 12.2 years (range: 6.8, 15.4 years). Significant differences were found between acculturation groups for children's tooth brushing frequency and school dental service enrollments but these differences did not moderate relationships between acculturation and oral health status. Unmet treatment need was significantly different between acculturation groups, with children of mothers having higher Pacific orientation having worse unmet needs than those with lower Pacific orientation. No other significant differences were noted.


CONCLUSIONS
Pacific children carry a disproportionate oral health burden, particularly amongst those with mothers more aligned to their Pacific culture. Strategies which enable Pacific people to re-shape their oral health understanding, together with reducing barriers to accessing dental health care, are needed to prevent a legacy of poor oral health in Pacific people within New Zealand.
School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand.|School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
Philip J
http://orcid.org/0000-0001-6799-6779
PJ
Schluter
Auckland Regional Dental Service, Waitemata District Health Board, Auckland, New Zealand.
Sathananthan
S
Kanagaratnam
Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.|Centre for Pacific Health and Development Research, Auckland University of Technology, Auckland, New Zealand.
Steve
S
Taylor
Centre for Pacific Health and Development Research, Auckland University of Technology, Auckland, New Zealand.
El-Shadan
ES
Tautolo
D000069:Acculturation; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D009520:New Zealand; D009909:Oral Health; D010139:Pacific Islands
Pacific children; acculturation; epidemiology; oral health; public health dentistry