Objective: This research was undertaken to explore factors operating at the level of the clinic and the community which influence the development of the oral health role of Indigenous Health Workers. The research is a significant aspect of a wider study of the disconnect between the strong national policy support for the development of the oral health role of Indigenous Health Workers and the limited development of the role. Design: Semi-structured interviews were conducted with Indigenous Health Workers to explore their perceptions of the priority of the development of an oral health role and to identify facilitators and barriers to sustainable role development. Setting: The study was conducted in three remote Indigenous communities and two regional centres of the Cape York region in far north Australia. Method: Interviews were conducted with 21 Indigenous Health Workers through five group interviews and eight individual interviews. Results: The findings highlight the high priority given by Indigenous Health Workers to the development of their oral health role while also identifying significant barriers to the sustainable development of this role. Conclusion: The identification of barriers to role development operating at the level of the clinic and the community helps to explain the disconnect between policy and practice in the development of the oral health role of these community health personnel.