This report provides the results of the Oral Health Survey of Inuit conducted by the Office of the Chief Dental Officer of Canada in conjunction with the Inuit Tapiriit Kanatami and the Government of Nunatsiavut, Department of Health and Social Development (Newfoundland and Labrador); Nunavut Tunngavik Incorporated (Nunavut); and the Inuvialuit Region Corporation (Northwest Territories). It provides estimates of the burden of oral health conditions as of 2008-2009 across all areas of Canada's north, except Nunavik. Although the Region of Nunavik chose not to participate in the survey, it is important to mention that they are in full support of the Inuit Oral Health Survey 2008-2009 results. Following the standards of the oral health module of the Canadian Health Measures Survey (OHM-CHMS), trained dentist-examiners examined 1216 Inuit ranging in age from 3 to 40+ years.
Compared to southern Canadians, more Inuit reported poor oral health and higher frequency of food avoidance and oral pain. Fewer than half made a visit for dental care even though very few reported that costs were a factor in avoiding visiting or accepting recommended treatment.
The prevalence of coronal caries was very high among Inuit. Over 85% of preschoolers had had dental caries with a mean of 8.22 deciduous (baby) teeth affected. By the time of adolescence, 97.7% had been affected and among the oldest adults, the disease had affected everyone. Counts of decayed missing or filled permanent teeth increased at every age - from 2 at age 6-11 years, to 9.5 for adolescents, to 15 at age 20-39 years and over 19 DMFT among older adults. The prevalence and mean DMFT counts greatly exceeded similar counts for southern Canadians.
Further, much of the disease remained untreated. As an example, the proportion of the affected teeth that remained decayed for adolescents and young adults was 38.1% and 16.7% respectively compared to 14.9% and 12.6% among southern Canadians. In addition, more of the disease is treated by extractions among the Inuit. Among adolescents there were 20.3 extractions per 100 filled; the OHM-CHMS found that among adolescents only 1.0 tooth had been extracted per 100 filled.
Root caries was also more prevalent and less was treated compared to the findings of the OHM-CHMS. On the other hand, periodontal conditions, as demonstrated by the CPITN Index, seemed less prevalent and less severe among Inuit compared to the findings of the OHM-CHMS and to the Alaskan Native patients.
Given that more extractions are provided, more of the oldest Inuit population (21.3%) than the southern population (4.4% to 21.7%) were edentulous. However the finding that 21.3% of older Inuit, aged 40 years+, were edentulous, is demonstrably lower (better) than both Galan et al. (1993) and Rea et al, (1993) found when they surveyed just the Keewatin Region.
The finding that Canada's Inuit had more dental disease (except for periodontal conditions) than their southern countrymen is consistent with international studies that have also found that indigenous people have worse oral health status compared to that of the dominant cultures in their countries.
While caries prevalence and severity has decreased somewhat among 6 year-olds the proportion of decayed teeth successfully treated among that same age-group has improved from 20% reported in 1992 to 55% in the present survey.
Still, the oral health conditions cannot be treated away even if more resources could be applied. More emphasis on community-based primary preventive measures backed up by early detection and prompt basic treatment would appear to be the best course to make a difference. However, these two strategies cannot do the job by themselves. The threats to health such as high rates of tobacco use, crowded housing and food insecurity which have been identified in earlier studies need to be addressed for the preventive dental efforts to have maximal effect.