Perspectives of patients, dental professionals, and stakeholders on the use of silver diamine fluoride for the management of dental caries: A qualitative systematic review.

OBJECTIVES: This qualitative systematic review and meta-aggregation aimed to synthesise evidence regarding perceptions of patients, practitioners, and stakeholders on the use of Silver Diamine Fluoride (SDF) for the management of dental caries. DATA: This review was reported in alignment with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and is registered with PROSPERO (CRD42023390301) and the Joanna Briggs Systematic Reviews register. SOURCES: References were retrieved from PubMed, Web of Science, Scopus, and EMBASE using a pre-established search strategy. STUDY SELECTION: Qualitative and mixed-methods studies examining perspectives of patients, practitioners, and/or stakeholders on the use of SDF were included. The initial search identified 650 articles eligible for inclusion, out of which 14 articles were included in the review. Reviewers synthesised findings and generated 11 distinct categories grouped into three synthesised findings: 1) Clinical use; 2) Staining; 3) Facilitators and barriers. CONCLUSIONS: Practitioners and patients viewed SDF as a therapeutic option with multiple benefits. While aesthetic concerns may be a barrier to some groups, the acceptance of the treatment was influenced by other factors, such as trusting professional advice. CLINICAL SIGNIFICANCE: Patient education is key for increased SDF acceptance. This systematic review can assist clinicians in addressing concerns regarding SDF therapy. Findings have the potential to inform policy decisions that address oral health inequities through patient-centred health care models.

Conceptualising the relationships between food sovereignty, food security, and oral health among global Indigenous Communities: A scoping review.

OBJECTIVE: Invasive colonial influences and continuing neoliberal policies have a detrimental impact on Land, health, food, and culture for Indigenous Communities. Food security and sovereignty have significant impacts on Indigenous wellbeing and specifically, oral health. Aspects relating to food security, such as availability of nutritious foods, are a common risk factor of oral diseases. This scoping review aimed to collate existing evidence regarding the relationship between food sovereignty and/or food security and oral health for Indigenous Communities, globally. DESIGN: Four databases were searched using keywords related to 'Food security' or 'Food sovereignty,' 'Indigenous Peoples,' and 'Oral health.' Duplicates were removed and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data was summarised narratively, presenting a conceptual model which illustrates the findings and relationships between food security and/or food sovereignty and oral health. RESULTS: The search identified 369 articles, with 41 suitable for full text review and a final nine that met inclusion criteria. The impact of food security and food sovereignty on oral health was discussed across different populations and sample sizes, ranging from 18 Kichwa families in Brazil to 533 First Nations and Metis households in Canada. Pathways of influence between food sovereignty and/or food security is explored clinically, quantitatively, and qualitatively across oral health outcomes, including early childhood caries, dental caries, and oral health related quality of life for Indigenous Communities. CONCLUSIONS: Innovative strategies underpinned by concepts of Indigenous food sovereignty are needed to promote oral health equity for Indigenous Communities. The nexus between oral health and Indigenous food sovereignty remains largely unexplored, but has immense potential for empowering Indigenous rights to self-determination of health that honour Indigenous ways of knowing, being, and doing.

Effect of sleep on oral health: A scoping review.

Sleep is a vital biological process that facilitates numerous vital functions integral to mental and physical restoration of the body. Sleep deprivation or poor sleep quality not only affects physical health but may also affect oral health. This scoping review aims to collate existing evidence related to the impact of sleep duration and/or quality on oral health. A systematic search strategy using PubMed, Embase, Scopus and CINAHL databases was performed to identify studies that assessed the association between sleep quality or duration and oral health or hygiene. Two researchers independently screened and extracted the data. Eligible studies were critically appraised using the NIH quality assessment tool for observational cohort and cross-sectional studies checklist. The search identified 18,398 studies, from which 14 fulfilled the inclusion criteria. Of the 14 papers, four papers were associated with effect of sleep on caries, 8 papers described the effect of sleep on gingival and periodontal health, and two papers described the effect of sleep on general oral health and oral disease symptoms. This review found a direct link between sleep and dental decay in children, and short sleep duration was associated with an increased risk of periodontitis adults.

Deadly places: The role of geography in Aboriginal and Torres Strait Islander COVID-19 vaccination.

OBJECTIVE: The objective of this study was to investigate the geospatial distribution of COVID-19 vaccination rates for Aboriginal and Torres Strait Islander Peoples across Local Government Areas in Australia. METHODS: We described the patterns of COVID-19 vaccination across jurisdictions, identified clusters with different levels of vaccination uptake, and assessed the relationship between contextual factors and vaccination (spatial error model, spatial lag model, and geographic weighted regression). RESULTS: The proportion of the Aboriginal and Torres Strait Islander population that received at least two doses of a COVID-19 vaccine by the last week of June 2022 ranged from 62.9% to 97.5% across Local Government Areas. The proportion of the overall population who is Aboriginal or Torres Strait Islander (ß = 0.280, standard deviation [SD] = 1.92), proportion of the total labour force employed (ß =0.286, SD = 0.98), and proportion of individuals who speak an Aboriginal or Torres Strait Islander language (ß =0.215, SD = 0.15) had, on average, the strongest effects on COVID-19 vaccination rates. CONCLUSION: Findings underscore the extent to which area-level demographic influence the COVID-19 vaccination for Aboriginal and Torres Strait Islander Australians. IMPLICATIONS FOR PUBLIC HEALTH: Findings can inform vaccination strategies that prioritise geographic areas with higher vulnerability to promote equity for Aboriginal and Torres Strait Islander Peoples.

Molar-root incisor malformation - a systematic review of case reports and case series.

OBJECTIVES: Molar-root incisor malformation (MRIM) is a seldom reported condition characterised by disturbances in root development of first permanent molars. This systematic review aimed to collate the clinical characteristics of individuals diagnosed with MRIM. MATERIALS AND METHODS: A systematic search strategy using PubMed, Embase, Web of Science, and SCOPUS databases was performed through to March 2023. Inclusion criteria were case reports or case series including a diagnosis consistent with MRIM. Critical appraisal for all included studies utilised the Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series and collation of clinical characteristics was performed in JBI System for the Unified Management, Assessment and Review of Information program. RESULTS: The search identified 157 studies from which 35 satisfied the inclusion criteria. After full-text review, a total of 23 papers described the MRIM dental anomaly and were included in this paper. A total of 130 reported cases were retrieved, with age ranging 3-32 years, and males affected 1.16:1 females. Presence of neurological conditions, premature birth history, medication, and surgery within first years of life were synthesised and described. CONCLUSIONS: The aetiology of MRIM is yet to be determined but epigenetic changes from significant medical history in the first years of life are likely to influence the development of this root malformation. First permanent molars were most commonly affected, but clinicians should be aware that permanent central incisors, primary teeth and other permanent teeth may also be affected.

Demystifying the connection between periodontal disease and chronic kidney disease - An umbrella review.

Chronic kidney disease (CKD) and poor oral health are inter-related and their significant impact on each other is well established in the literature. Many systematic reviews and meta-analyses have demonstrated a strong relationship between CKD and periodontitis, where periodontal treatment has shown potential in improving CKD outcomes. However, the quality of the studies and heterogeneity of the results show variation. The aim of this umbrella review was to review the quality of the current systematic reviews on the relationship between CKD and oral health with an emphasis on periodontal disease and to generate clinically relevant guidelines to maintain periodontal health in patients with CKD. This umbrella review was conducted and reported in alignment with the Joanna Briggs Institute and the PRISMA 2020 guidelines. The review protocol was established prior to commencing the review and registered on JBI and PROSPERO (CRD42022335209). Search strings were established for PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and Dentistry & Oral Science Source up to April 2022. All systematic reviews and meta-analyses that considered the relationship between CKD and periodontitis or periodontal treatment were included. Of 371 studies identified through the systematic search, 18 systematic reviews met the inclusion criteria. Ten studies assessed the relationship between oral health status and CKD with a focus on periodontitis and CKD, five reviewed the impact of periodontal treatment on CKD outcomes, two included both relationship and effectiveness of periodontal treatment and one qualitatively reviewed oral health-related quality of life in patients with kidney failure. Findings indicate there is a bidirectional relationship between CKD and periodontal disease. In view of the heterogeneity of the existing literature on CKD and periodontal disease, specific recommendations for the management of periodontitis among patients with CKD are proposed for medical professionals, dental professionals, and aged care workers based on the evidence collated in this review.

Facilitators and Challenges to Maintaining Oral Health for Indigenous Communities Globally: A Qualitative Systematic Review.

Globally, Indigenous Peoples experience pervasive oral health inequities due to a complex interplay of social determinants of health including the sustained effects of colonisation, racism, and intergenerational disruption to Indigenous communities. This qualitative systematic review aimed to synthesise evidence related to facilitators and challenges that affect the ability of global Indigenous communities to maintain oral health. Two independent reviewers searched PubMed, SCOPUS, Web of Science, and Embase. Qualitative studies including illustrations from Indigenous Peoples regarding facilitators and challenges to oral health maintenance were considered. Included articles were critically appraised. The search identified 4,247 articles eligible for inclusion; 22 articles were included. Challenges and facilitators were synthesised across child, carer, community, and service levels during the meta-aggregation. The prioritisation of integrated oral health services, programs, and research that encompass multiple factors at various levels of influence are needed to strengthen the oral health of Indigenous communities.

Journeying towards decolonising Aboriginal and Torres Strait Islander oral health re-search.

OBJECTIVES: Arguably, the deficit narrative of oral health inequities, perpetuated by colonial re-search agendas, media and sociopolitical discourse, contributes to oral disease burden and fatalism among Aboriginal and Torres Strait Islander Peoples. There remains a need to evolve the way oral health is understood, in a manner that reflects the lived experiences of Aboriginal and Torres Strait Islander Peoples. METHODS: This paper proposes decolonising methodologies as a strategy to ensure oral health re-search creates more equitable oral health outcomes and realities for Aboriginal and Torres Strait Islander Communities. Anchored by a critical reflection of the failure of dominant oral health inequity re-search practices to address Indigenous oral health, both in Australia and internationally, we propose five explicit pathways for decolonising Aboriginal and Torres Strait Islander oral health re-search. RESULTS: We argue the need for (1) positionality statements in all re-search endeavours, (2) studies that honour reciprocal relationships through the development of proposals that ask questions and follow models based on Traditional Knowledges, (3) the development of culturally secure and strengths-based data capturing tools, (4) frameworks that address the intersection of multiple axes of oppression in creating inequitable conditions and (5) decolonising knowledge translation techniques. CONCLUSION: Importantly, we recognize that re-search will never be entirely 'decolonised' due to the colonial foundations upheld by academic institutions and society more broadly; however, as oral health re-searchers, we ascertain that there is an ethical compulsion to drive decolonising re-search pursuits that produce equitable oral health outcomes for Aboriginal and Torres Strait Islander Communities.

From biocolonialism to emancipation: considerations on ethical and culturally respectful omics research with indigenous Australians.

As part of a (bio)colonial project, the biological information of Indigenous Peoples has historically been under scientific scrutiny, with very limited benefits for communities and donors. Negative past experiences have contributed to further exclude Indigenous communities from novel developments in the field of omics research. Over the past decade, new guidelines, reflections, and projects of genetic research with Indigenous Peoples have flourished in Australia, providing opportunities to move the field into a place of respect and ethical relationships. This review explores the ethical and cultural implications of the use of biological samples from Indigenous communities in biomedical research. A structured framework outlining emerging topics of interest for the development of respectful omics research partnerships with Indigenous Australians is presented. This paper highlights aspects related to Indigenous governance, community and individual consent, respectful handling of biological samples, data management, and communication in order to protect Indigenous interests and rights and to promote communities' autonomy.

Non-traumatic emergency department dental visits among patients 0-25 years of age: A systematic review and meta-analysis.

BACKGROUND: Nontraumatic dental conditions (NTDC) that made children attending to emergency departments (EDs) of tertiary hospitals can put significant financial and time strain on hospitals. AIM: The aim of this systematic review and meta-analysis was to calculate the prevalence of paediatric presentations to EDs of tertiary hospitals for NTDC and describe the characteristics of these presentations. DESIGN: A systematic search strategy using PubMed, Embase and Web of Science databases was performed to identify studies quantifying NTDC presentations to EDs of tertiary hospitals from inception through to July 2022. Eligible studies were critically appraised using the Joanna Briggs Institute checklist for studies reporting prevalence. RESULTS: The search identified 31 099 studies, from which 14 were found to meet the inclusion criteria. A random effects model was used for meta-analysis, and the prevalence of NTDC reported through EDs of tertiary hospitals ranged from 52.3% to 77.9%. CONCLUSIONS: Nontraumatic dental conditions, which may be preventable when caused by dental caries, made up a high proportion of dental visits to tertiary hospital EDs. Public health initiatives should be considered to reduce the burden of NTDC on EDs.

The future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past: Re-framing oral health discourse.

OBJECTIVE: The history of oral health research and dental care provision for Aboriginal and Torres Strait Islander Peoples has been framed by oppressive colonial values and wrought with maltreatment and unethical behavior. This commentary aims to collate evidence regarding the healthy history of Aboriginal and Torres Strait Islander oral health, the implications of colonization on oral health, and the current portrayal of oral health. CONCLUSION: We argue the need to reframe deficit focused discussions of Aboriginal and Torres Strait Islander oral health to strengths-based narratives by critically engaging with the ways in which the future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past.

"We Need to Live off the Land": An Exploration and Conceptualization of Community-Based Indigenous Food Sovereignty Experiences and Practices.

Although Indigenous food systems are sustainable in nature, many of these systems have been forcibly altered among Indigenous communities within Canada, as a consequence of colonization. Indigenous Food Sovereignty (IFS) movements work to counteract the dismantling of Indigenous food systems as well as the negative health impacts of environmental dispossession experienced by Indigenous communities. Through community-based participatory research methodologies and the utilization of Etuaptmumk, or two-eyed seeing, this research project explored community perspectives of IFS in Western Canada. Reflexive thematic analysis of qualitative data collected during a sharing circle held with community members identified the influence of Indigenous Knowledge and community support on three main aspects of Indigenous food sovereignty, including (1) environmental concerns, (2) sustainable practices and (3) a strong relationship with the land and waters. Through the sharing of stories and memories related to traditional foods and current sovereignty projects, community members identified concerns for their local ecosystem as well as a desire to preserve its natural state for generations to come. The strengthening of IFS movements is critical to the overall wellbeing of Indigenous communities within Canada. Support is needed for movements that honour relationships with traditional foods and recognize traditional lands and waters as necessary for healing and sustaining the health of Indigenous communities.

Toxicity with proton therapy for oral and/or oropharyngeal cancers: A scoping review.

BACKGROUND: Oral and/or oropharyngeal cancers account for approximately 2% of all malignancies, with variation across age groups, genders, and geographic locations. Treatments for oral and/or oropharyngeal cancers usually consist of a combination of surgical excision most commonly followed by radiotherapy ± chemotherapy and/or immunotherapy/biotherapy depending on the nature of the malignancy. The significant morbidity caused by high-dose radiotherapy to the head and neck region is widely observed. Proton therapy is a promising treatment option that localises a proton beam to direct radiation at a specific target, with reduced irradiation to adjacent structures. METHOD: The objective was to explore the toxicity associated with proton therapy for adults with oral and/or oropharyngeal cancer. Eligibility criteria included full-text articles, English articles, published between up till 7 January 2023. Databases included PubMed, Scopus, Web of Science, Embase, and Scopus. RESULTS: The systematic search identified 345 studies and a total of 18 studies were included after two independent reviewers completed title, abstract, and full-text screening. Included studies were from four countries, and median participant age range was 53.3 to 66 years. The most commonly reported acute toxic effects included dysphagia, radiation dermatitis, oral mucositis, dysgeusia, and alopecia. CONCLUSION: Proton therapy is an evolving cancer treatment technique that has diverse advantages over conventional radiotherapy and chemotherapy. This review provides evidence that supports that proton therapy has an improved acute toxicity profile compared to radiotherapy to treat oral and/or oropharyngeal cancer individuals.

School lunchboxes as an opportunity for health and environmental considerations: a scoping review.

Very little research has focussed on children's school lunchboxes from both a health and environment standpoint. This scoping review explores studies that considered children's lunchbox food consumption trends at school and the environmental impacts of lunchbox contents. We conducted a scoping review of peer-reviewed literature with a focus on lunchboxes of children in preschool or primary school settings that contained food packed from home, through the lens of food and nutrition in combination with environmental outcomes-particularly food and/or packaging waste. The review included 10 studies, with articles from Australia, USA, Spain, New Zealand and the UK. Half of them were intervention studies aiming to shift knowledge levels and attitudes of teachers, parents and children with regard to reducing packaged food choices and food waste, and improving dietary habits. Acknowledging the complexity of lunchbox packing and consumption practices, this review recommends the consideration of socio-ecological influences on children's health and sustainability behaviour, and mobilizing their pro-environmental agency.

School food environments play a key role in children's health and behaviour development. However, there are environmental implications of school food and this is not often considered in conjunction with schoolchildren's health based on their food consumption patterns. While wider environmental impacts of school food provision models have been studied, the more immediate and child-relevant outcomes (such as food and packaging waste) are also worth considering, especially in the context of school lunchboxes. This scoping review explored the existing literature for studies that focussed on school children's lunchbox contents and considered health attributes along with packaging and waste characteristics. Results from this review of 10 articles, which also describes the five interventions identified, pointed towards the merit of tapping into children's agency of change while also recognizing socio-ecological influences to drive sustainability practices for health co-benefits. The interconnectedness of nutritional quality and sustainability characteristics of school lunchboxes is an understudied phenomenon, but one with promising potential to promote and improve public health and planetary wellbeing.

Childhood Experiences and Perspectives of Individuals With Orofacial Clefts: A Qualitative Systematic Review.

OBJECTIVE: Children and adolescents with orofacial clefts may experience ongoing psychosocial impacts due to the continuous nature of cleft treatments, facial and dental differences, and speech and hearing difficulties. The aim of this qualitative systematic review was to better understand the experiences of children and adolescents with orofacial clefts. DESIGN: A systematic search strategy using PubMed, Embase, Emcare, Scopus, and Web of Science databases was performed to identify relevant qualitative studies evaluating the lived experience of children and adolescents with orofacial clefts from inception through to June 2021. Eligible studies were critically appraised using the Joanna Briggs methodology and a meta-aggregative approach. RESULTS: The search identified 2466 studies, with 13 found to meet the inclusion criteria. Extraction of 155 findings resulted in 27 categories, which were meta-aggregated into 7 overarching synthesized findings. These 7 core findings included aspects of child experience and findings that enhanced or impeded child experience at the individual, family, and community levels. CONCLUSIONS: Factors that impeded child experience at the individual, family, and community levels were more pronounced than factors that enhanced their experience among children and adolescents with orofacial clefts. Further initiatives are needed to provide support to individuals, families, and school communities to enhance children's experience of orofacial cleft during the formative childhood and adolescent years.

Building an understanding of Indigenous Health Workers' role in oral health: A qualitative systematic review.

OBJECTIVES: Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitative systematic review aimed to build an understanding of IHW insights on oral health. METHODS: Two independent reviewers searched PubMed, EMBASE, Web of Science and Scopus using a pre-established search strategy. Qualitative studies that included IHW illustrations about oral health were considered. The search was not limited by geographic setting. Included articles were critically appraised with the Joanna Briggs Institute appraisal tool for qualitative studies. RESULTS: The search identified 1856 articles eligible for inclusion; a total of 10 articles were included. Four synthesized findings were identified during the meta-aggregation: oral health challenges in community, systemic barriers limiting IHW ability to support oral health, benefits of IHW involvement in oral health and avenues to increase IHW involvement in oral health. CONCLUSION: The prioritization of Indigenous leadership in oral health has the potential to address many of the current challenges Indigenous communities face. Future works need to determine the capacity of IHW to provide oral health care and explore opportunities to create specific oral health roles for IHW.

Development of Social Determinants of Health Screening Tool (SDoHST): qualitative validation with stakeholders and patients in South Australia.

BACKGROUND: It is well-established that social determinants of health contribute to health and well-being. Among the social determinants of health, health-related social needs (HRSNs) are unmet needs that can be identified by the health care system and addressed through referral to community services. Despite the importance of identifying patients with HRSNs, none of the few screening tools for HRSNs available internationally have received a comprehensive psychometric validation. This study aims to conduct a qualitative validation of the Social Determinants of Health Screening Tool (SDoHST). METHODS: This study took place at Lyell McEwin Hospital, a major tertiary hospital located in Adelaide, South Australia. Patient (n = 5) and stakeholder (n = 9) focus groups were conducted face to face, audio recorded, and transcribed verbatim. Inductive content analysis of focus group transcripts was performed to inform tool modifications (e.g. item rewording). RESULTS: The patient focus group recommended the addition of an explanatory paragraph to improve face validity, and highlighted the importance of reliable transport and internet access. The stakeholder focus group recommended using language that carries less stigma to this particular community and incorporating questions surrounding cultural, linguistic, and spiritual needs. The final version of the SDoHST included 12 items (four original items were removed and seven new items were added during the validation process). CONCLUSION: The SDoHST is the first validated tool to measure social determinants of health (and specifically HRSNs) in Australia, receiving a comprehensive qualitative validation. The instrument is readily available and future studies will further investigate its psychometric properties with quantitative methods.

A brief guide to screening tools for social determinants of health and their validationThe importance of social context in contributing to overall health is well-established. Social determinants of health (SDoH) are social and environmental factors such as employment, housing security, financial stability, social isolation, and personal safety, which contribute up to 60% of overall health.In recent years, there has been a paradigm shift in how healthcare systems view health and wellbeing. There is a growing call to intervene in adverse SDoH from within the healthcare system. One such intervention involves screening patients for unmet needs, such as housing or food insecurity, and providing appropriate connections to organizations in the community to assist with their needs.The screening tools implemented in this context are multiple and diverse. Some target only one or two factors while others assess multiple SDoH. However, little is reported about the development of these tools. If a screening tool is not thoroughly developed and validated, it is impossible to know whether the data collected with the tool are appropriate or relevant. This study details the development and validation of a screening tool for unmet social needs by community members and healthcare providers at a major metropolitan hospital in South Australia.

Maximizing Oral Health Outcomes of Aboriginal and Torres Strait Islander People With End-stage Kidney Disease Through Culturally Secure Partnerships: Protocol for a Mixed Methods Study.

BACKGROUND: Dialysis for end-stage kidney disease (ESKD) is the leading cause of hospitalization among Aboriginal and Torres Strait Islander individuals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving kidney transplant. OBJECTIVE: This study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD in South Australia through the following objectives: investigate the facilitators of and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia; investigate the facilitators of and barriers to maintaining oral health among Aboriginal and Torres Strait Islander people with ESKD in South Australia; facilitate access to and completion of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD and their families; provide oral health promotion training for Aboriginal health workers (AHWs) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD; generate co-designed strategies to better facilitate access to and provision of culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD; and evaluate participant progress and AHW oral health training program. METHODS: This collaborative study is divided into 3 phases: exploratory phase (baseline), intervention phase (baseline), and evaluation phase (after 6 months). The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care; the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops; and the evaluation phase will involve 6-month follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training. RESULTS: Stakeholder interviews were initiated in November 2021, and participant recruitment commenced in February 2022. The first results are expected to be submitted for publication in December 2022. CONCLUSIONS: Expected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges regarding oral health for individuals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant-identified and stakeholder-identified challenges to ensure accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander individuals with ESKD. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/39685.