Where do traditional healers fit in the dentist-centred oral health system? An ethnography inquiry among the indigenous communities in Gudalur, South India.

Background: Adivasi (Indigenous) communities in Gudalur, Tamil Nadu, India, face significant challenges in accessing equitable oral health care, influenced by cultural and socio-political factors. This study examines the role of traditional herbal medicine healers in delivering oral health services within these communities. Methods: Guided by the Socio-Ecological Framework, the data were collected between April 2015 and July 2018, employing ethnography tools such as participant observation, focus group discussions, and semi-structured interviews. A total of twenty-four healers took part, offering insights into how Adivasi healers perceive and treat oral health issues. The study also incorporated perspectives from community members, dentists, and doctors to provide a broader understanding of oral healthcare within the community. Results: Adivasi healers identified overlapping oral health symptoms and provided local care that fills gaps in the formal health system. Challenges such as resource limitations and competition with Western biomedicine affect the continuity of their practices. Oral health among Adivasis is deeply intertwined with cultural and structural determinants, exacerbated by marginalisation within the mainstream public healthcare system. Conclusion: Local health traditions, particularly those practised by Adivasi healers, play a crucial role in primary oral health care where formal dental services are inadequate. Addressing oral health disparities requires a shift towards inclusive, community-oriented health systems that recognise and integrate local healing practices.