Abstract

Background: The persistent oral health disparities affecting children of colour represent a manifestation of colonial structures embedded within healthcare systems. Objective: This perspective examines how decolonisation theory provides a framework for understanding and addressing racial inequities in paediatric oral health. Specifically, it analyses how colonial legacies and structural racism influence oral health outcomes among children from Indigenous and Black populations, and proposes a racial justice framework to guide more equitable and culturally responsive paediatric dental care. Methods: By analysing colonial legacies that shape contemporary dental care delivery, we explore how Western biomedical models have marginalised Indigenous and traditional healing practices while perpetuating systemic barriers to care. This perspective paper draws on existing scholarship on oral health inequalities, structural racism in healthcare systems, and decolonisation theory to examine how historical and contemporary power structures influence paediatric dental care. The discussion integrates evidence and concepts presented throughout the paper, including research on oral health disparities among Indigenous populations, institutional racism frameworks such as those articulated in the Stephen Lawrence Inquiry, and insights from racial justice movements. These perspectives are used to analyse how current paediatric dental care systems reproduce inequities and to identify community-centred and culturally responsive approaches that may contribute to more equitable child oral health outcomes. Results: Through a racial justice lens informed by the Stephen Lawrence Inquiry and Black Lives Matter movement, we propose transformative approaches that centre community knowledge, cultural practices, and self-determination in child oral health promotion. Conclusion: This framework calls for fundamental restructuring of paediatric dental services to honour diverse healing traditions, address institutional racism, and empower communities to lead their own oral health initiatives. Achieving oral health equity requires not merely addressing access barriers but fundamentally transforming the epistemological foundations of paediatric dental care to challenge existing power structures and create more equitable, culturally responsive systems of care.

Keywords

oral health inequalities, pediatric dentistry, decolonization, racial justice, indigenous health, social determinants, structural racism, health equity