A qualitative study to explore oral health related social practices in children from immigrant Indian families in Australia using social practice theory

Immigrants in high-income countries experience disproportionately high rates of oral diseases compared to the general population. Existing research largely focuses on biomedical models, individual behaviours or cultural factors providing limited insights into how everyday practices shape oral health outcomes. This study explored how oral health social practices were performed, sustained and/or modified within Indian immigrant families with young children in Australia. A qualitative study was conducted using semi-structured interviews with 17 participants (12 mothers, 5 service providers), using focused ethnography and a social practice theory lens (based on Shove et al.), beginning with inductive coding followed by deductive coding to identify practices and their elements. Social practices such as teeth cleaning/brushing, mouth rinsing, flossing, tongue cleaning and mouth wiping, along with feeding/eating and health advice seeking, along with their elements (meanings, materials and competences) were identified as shaped by intergenerational knowledge of hygiene and care, children wanting to fit in, acculturation and protecting cultural identity. By exploring social practices, and their elements this research offers a new way to engage families into focusing on their everyday routines to understand what supports or undermines performances of oral health related practices rather than solely focusing on persuading individuals to follow recommended behaviours.