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Synopses of articles in PubMed:
1. J Public Health Dent. 1994 Fall;54(4):220-7.
A comparison of dental caries experience in Native American and Caucasian children in Oklahoma.
Grim CW, Broderick EB, Jasper B, Phipps KR.
Albuquerque Area Indian Health Service, NM.
OBJECTIVES: In 1989 the Oklahoma Area Indian Health Service conducted an oral health survey of children attending public schools in Oklahoma to determine the extent of caries experience in the Native American population. Results were to be used to establish program priorities, gather baseline data, and compare the oral health status of Native American children with their non-Indian peers. METHODS: A total of 934 elementary schoolchildren 5-6 years of age were examined along with 733 high school students 15-17 years of age. The study was designed so that approximately 50 percent of the students examined were Native American. RESULTS: The mean dmfs for the 5-6-year-olds was 5.06 for the Caucasian children and 10.35 for the Native American children, a statistically significant difference (P < .001). For the 15-17-year-olds the mean DMFS for the Caucasian students (5.99) was significantly lower (P < .001) than the mean DMFS for the Native American students (10.12). CONCLUSIONS: The prevalence and severity of caries in these Native American students appear to be substantially higher than in their non-Indian peers residing in the same communities. Further study is needed to identify factors contributing to these demonstrated differences in caries experience.
Order the article through PubMed (PMID: 7799296 [PubMed - indexed for MEDLINE])
2. Arch Oral Biol. 1960 Jan;1:193-205.
A survey of the oral health of Navajo Indian children.
Parfitt GJ.
Order the article through PubMed (PMID: 14430404 [PubMed - indexed for MEDLINE])
Assessment of a dental disease prevention program after three years.
Malvitz DM, Broderick EB.
Centers for Disease Control, Atlanta, GA 30333.
This assessment compared routine data on selected clinical services provided within the Oklahoma City Area of the Indian Health Service during the first six months of fiscal year 1984, prior to implementation of a program emphasizing oral health promotion and disease prevention, to comparable data from 1987. The assessment revealed: similar absolute numbers of routine examinations and completed treatment among children; a 10 percent increase in total visits for persons of all ages, accomplished with comparable numbers of dental personnel; and an increase in the percent of services that were preventive, as well as a concomitant decrease in basic restorative services. The ratio of pit and fissure sealants to one-surface amalgam restorations was reversed dramatically. Although counts of services rendered do not measure oral health status directly, some conclusions are warranted. Clinical dental personnel can be reoriented to devote an increased proportion of available patient care time to primary preventive services, accomplishing a substantial increase in these services. That increase is associated with a corresponding decrease in the proportion of basic restorative services.
Order the article through PubMed (PMID: 2911080 [PubMed - indexed for MEDLINE])
3. J Public Health Dent. 2000;60 Suppl 1:250-5.
Estimating dental treatment needs among American Indians and Alaska Natives.
Broderick EB, Niendorff WJ.
Indian Health Service, Parklawn Building, Room 6A-30, 5600 Fishers Lane, Rockville, MD 20857, USA. ebroderi@hqe.ihs.gov
OBJECTIVE: This paper describes the treatment needs of the American Indian and Alaska Native (Native American) population estimated from the 1991 Indian Health Service Oral Health Status and Treatment Needs Survey (1991 IHS patient survey). METHODS: The average per capita treatment need for the population is expressed both as the number of dental services and clinical time required to provide these services. Values for service minutes also are used to compare treatment needed with the treatment provided. RESULTS: The need for dental care is greatest among adults aged 25-54 years. We anticipate that needs will increase with population growth and as teeth are retained longer. Large amounts of dental needs go unmet each year in the Native American population: because resources are not available to provide all needed care, dental services are prioritized and rationed. The basic premise upon which care is rationed is changing from basic care for all who have access, to more complex care for fewer individuals. This trend may be driven by the opportunity to generate third party revenue offered by more complex procedures. CONCLUSION: Evaluation is needed of the effects of new approaches on oral health and access to dental care.
Order the article through PubMed (PMID: 11243043 [PubMed - indexed for MEDLINE])
4. J Public Health Dent. 2000;60 Suppl 1:236-7.
Indian Health Service oral health survey of American Natives. Preface.
Jones C.
Indian Health Services Dental Disease Prevention Program, Parklawn Building, Room 6A-30, 5600 Fishers Lane, Rockville, MD 20857. jonesc@hqe.ihs.gov
Order the article through PubMed (PMID: 11265662 [PubMed - indexed for MEDLINE])
5. Alaska Med. 2002 Oct-Dec;44(4):83-7.
Comment in:
• Alaska Med. 2003 Apr-Jun;45(2):57.
Oral health of young Alaska Native children and their caregivers in Southwestern Alaska.
Lewis CW, Riedy CA, Grossman DC, Domoto PK, Roberts MC.
Child Health Institute, Division of General Pediatrics, University of Washington, Seattle, WA 98195-4920, USA. cwlewis@u.washington.edu
OBJECTIVE: We sought to determine the prevalence of caries and associated risk factors in young Native children and their caregivers in two communities in rural Alaska. METHODS: A random sample of Alaska Native children between 12-36 months and a subset of their caregivers from two Southwestern Alaska communities were examined for dental decay. Caregivers completed a 43-item questionnaire about oral hygiene, dietary and other practices. RESULTS: Of the 65 children examined, 59% had evidence of decay. Among the 41 primary caregivers examined, 98% had experienced dental decay with an average of 11.4 decayed, missing, and filled teeth. On linear regression analyses, factors significantly associated with more decay in the children included a child taking a juice-containing bottle to bed, eating candy 1 or more times per day, and higher caregiver oral S. mutans counts. CONCLUSIONS: Our results suggest that preventive efforts for children at high risk for dental decay should begin early in life, should emphasize decreasing candy and bedtime juice bottle use, and should consider the caregivers’ oral health status in addition to the child’s.
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6. J Prev Dent. 1976 Jul-Aug;3(4):5-8.
Parental dental health education. Non-effect on oral hygiene among American Indian pre-school (headstart) children.
Bird WF, Hazel DR.
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7. J Public Health Dent. 2000;60 Suppl 1:243-9.
Prevalence and severity of dental caries among American Indians and Alaska Natives.
Niendorff WJ, Jones CM.
Indian Health Service, Parklawn Building, Room 6A-30, 5600 Fishers Lane, Rockville, MD 20857, USA.
OBJECTIVES: This paper reports findings from the 1991 IHS Patient Oral Health Status and Treatment Needs Survey (1991 IHS patient survey) and presents trends in caries among American Indian and Alaska Native (Native American) populations since 1957. METHODS: The 1991 IHS patient survey obtained data from approximately 10 percent (25,000) of the dental patients seen annually at IHS, tribal, and urban Indian clinics. The results of this survey are compared descriptively with previous surveys conducted by the IHS beginning in 1957. RESULTS: Findings from the 1991 IHS patient survey indicate that Native Americans experience a much higher prevalence of dental caries in their primary and permanent dentitions than the general US population. However, caries rates in Native American children peaked in 1983-84 and have been going down since that time. CONCLUSIONS: While progress has been made in preventing dental caries among Native Americans, the high prevalence and severity at all ages in this rapidly growing population have resulted in a large backlog of untreated disease with an overwhelming demand on the resources available to provide care. Continued emphasis on dental caries prevention and health promotion is an important part of the solution. New strategies such as targeting preventive services toward individuals and groups with the highest risk of disease and the use of modern conservative treatment methods to control disease must be employed. Full implementation of these strategies and identification of the resources required will depend upon new and ongoing partnerships among tribes, federal and state governments, and the private sector.
Order the article through PubMed (PMID: 11243042 [PubMed - indexed for MEDLINE])
8. J Public Health Dent. 1987 Spring;47(2):94-7.
The prevalence of baby bottle tooth decay among two native American populations.
Kelly M, Bruerd B.
Baby bottle tooth decay (BBTD) is a disease characterized by severe dental caries in the primary dentition that may have significant short-term and long-term implications for the health of children. Its prevalence and various etiologic factors have not been addressed fully in the dental literature. In 1985, 514 Native American Head Start children in Alaska and Oklahoma were screened to establish the prevalence of BBTD in those populations. The prevalence of BBTD ranged between 17 and 85 percent, with a mean of 53 percent. BBTD is clearly a significant health problem for this population group. Concerted intervention efforts to lower the prevalence of this preventable condition should be instituted and their effectiveness evaluated for potential utility among other affected groups.
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9. Matern Child Health J. 2008 Jul;12 Suppl 1:64-7. Epub 2007 Oct 24. Links
An observational study of the association of fluoride varnish applied during well child visits and the prevention of early childhood caries in American Indian children.
Holve S.
Tuba City Regional Health Care Corporation, P. O. Box 600, Tuba City, AZ 86045, USA. sholve@frontiernet.net
OBJECTIVES: To determine if fluoride varnish applied at well child care visits would decrease the prevalence of dental caries in a group of American Indian children at high risk for early childhood caries. METHODS: This was an observational study in an American Indian community. Starting in 2002 all children received fluoride varnish applications at well child care visits at 9, 12, 15, 18, 24 and 30 months. The Head Start class of 2003 served as historical controls and students in 2004 and 2005 had increasing number of fluoride varnish treatments. All children entering Head Start from 2003 to 2005 had dental exams to determine the number of decayed, missing and filled surfaces (dmfs) present. The number of dmfs for each child was correlated with the number of fluoride varnish treatments received. RESULTS: Children with 4 or more treatments had 15.5 dmfs (95%CI 10.8-20.4) versus children with no fluoride varnish treatments who had 23.6 dmfs (95%CI 19.5-25.8) for a 35% decrease in overall caries. Children who received 1, 2 or 3 treatments showed no significant difference in dmfs when compared with children who had no fluoride varnish applications. CONCLUSIONS: Fluoride varnish applied at well child care visits can reduce early childhood caries in American Indian children. Consideration should be given to making fluoride varnish more available to American Indian and Alaska Native children at well child visits. These findings may be applicable to other children who are at increased risk for early childhood caries.
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10. J Public Health Dent. 2006 Winter;66(1):23-9. Links
Associations of ethnicity/race and socioeconomic status with early childhood caries patterns.
Psoter WJ, Pendrys DG, Morse DE, Zhang H, Mayne ST.
New York University College of Dentistry, Department of Epidemiology & Health Promotion, 345 East 24th Street, New York, NY 10010, USA. wp9@nyu.edu
OBJECTIVES: The purpose of this project was to evaluate ethnicity/race, household income and caregiver education level as predictors of (1) any early childhood caries, and (2) each of four proposed patterns of primary dentition caries. METHODS: Between February 1994 and September 1995, five examiners visually examined Arizona pre-school children ages 5-59 months old. Self-reported demographic information including family income, caregiver education level and ethnicity/race were obtained at the time of examination. Multivariate analyses were conducted to assess the association of income, education and ethnicity/race with a child having any caries and with each of the proposed caries patterns seen in 3850 examinations. RESULTS: Income and education were inversely associated with: (1) any early childhood caries, and (2) the maxillary incisor caries pattern. A positive association between these caries patterns and minority ethnicity/race status was also identified. Three additional caries intraoral patterns demonstrated more varied associations with socioeconomic status (SES), ethnicity/race and income and education. CONCLUSIONS: This study supports the association of both ethnicity/race and social status with any early childhood caries. The patterns of caries were each found to be associated with specific and different socioeconomic-demographic indicators. The practical importance of these findings is that global measurement of ECC, without regard to specific caries pattern, leads to the potential for substantial non-differential misclassification of disease. The consequence of this is the potential for important ECC-SES-ethnicity/race associations to be masked. This, in turn, decreases the ability of surveys and investigations to accurately identify sub-groups of the population at greatest risk of developing ECC.
Order the article through PubMed (PMID: 16570747 [PubMed - indexed for MEDLINE])
