CDA Essentials 2018 • Volume 5 • Issue 5

26 | 2018 | Issue 5 I ssues and P eople “We know that data tell one story,” says Dr. Mary McNally, professor in the faculties of dentistry and medicine at Dalhousie University and a member of the research team. “But there are often many other stories within the community that give context and understanding to the data.” Their study 1 was guided by “two-eyed seeing,” an approach to understanding issues that recognizes both Indigenous and Western knowledge. “Two- eyed seeing acknowledges that we can see the world through one eye, which is the Western scientific way, but we can also see the world through another eye, which is Indigenous peoples’ ways of understanding the world,” says Dr. Debbie Martin, Canada Research Chair in Indigenous peoples’ health and well-being, and associate professor in health promotion at Dalhousie University and lead study author. “The advantage of two-eyed seeing is that it attempts to bring these diverse perspectives together to get a better understanding of the issues that we’re trying to address.” Three major themes emerged from their conversations: 1. Holistic conceptualizations of health are essential for good oral health. Researchers identified areas where a gap between Inuit knowledge and Western science may limit the success of public health initiatives that promote oral health. For instance, in the past, conventional preventive oral health behaviours like brushing and flossing might not have been considered a priority since it requires a scarce resource: clean water. Since a municipal source of clean tap water was not available (and is still not available in all NunatuKavut communities), water for tooth brushing had to either be boiled or collected from a safe natural water source. Historically, living off the land provided Inuit with much of what they needed. “People had protective measures in place that would have protected them against oral diseases,” explains Dr. Martin. “For example, chewing bones and marrow cleaned teeth naturally and anesthetics came from birch and willow, directly from the natural environment.” This idea of community-level health that is directly connected to the natural environment also seemed incompatible with the conventional public health focus on learning about “good oral health.” Inuit conceptions of health are more holistic, where the mouth is not separate from the body, family, community and natural environment. 2. Achieving optimal oral health is prohibitive for Inuit communities. “There was an assumption that people on the coast were not engaging in oral health practices because they were somehow deficient of knowledge about how to look after themselves,” says Dr. Martin. “And in fact, the research that we’ve done has uncovered that people are very knowledgeable about oral health care.” The researchers found that most youth know how and when to brush and floss, what foods and drinks to limit, saw a dentist regularly, and were supported through health promotion programs, including oral health education in schools and local family resource centres. Despite this, youth are limited in crucial ways when it comes to maintaining their oral health. The study authors note that good oral health requires “accessible healthy foods, safe drinking water and "Two-eyed seeing acknowledges that we can see the world through one eye, which is the scientific way, but we can also see the world through another eye, which is Indigenous peoples’ ways of understanding the world." – Dr. Debbie Martin Dr. Mary McNally (r.) using the knee-on-knee technique to give an oral examination to a very young resident of NunatuKavut.