New Native American Oral Health Improvement Study

Many Native American of all ages, are without adequate, or timely access to dental care, and are severely affected by tooth decay.  Toddlers, and youngsters were deemed to be most at risk.  A study by the Northwest Portland Area Indian Health Board (NPAIHB) and Kaiser Permanente Center for Health Research (KPCHR) joined in partnership with six Northwest tribes to conducted a research study to reduce childhood obesity, and dental cavities.  The aim of the study was to determine if community based interventions can alter feeding practices, influence parents to reduce sedentary lifestyles, and if such changes can reduce childhood obesity and early childhood tooth decay.  The TOTS Study is a federally funded health research study sponsored by the National Heart Lung and Blood Institute (NHLBI) at the National Institutes of Health (NIH).


According to the TOTS study, which targeted American Indians from birth to 30 months of age, when the toddlers were switched from soda to water, “a decrease of between 30 and 63 percent in early stage, potentially reversible tooth decay, was noted”  said Gerardo Maupomé, B.D.S., M.Sc., Ph.D., professor of preventive and community dentistry at the Indiana University School of Dentistry.   These results appear in the current issue (Volume 20, Number 4) of the peer reviewed journal Ethnicity & Disease.

The researchers worked closely with tribal councils. In three of the four communities, fresh water was made available via water fountains and refillable jugs. Soda was removed from tribal stores, and substitution of water for soda was encouraged through community outreach programs. Families received food counseling and breastfeeding support via tribal health workers.

“After the successful switch to water, we compared the rate of tooth decay in children born in these three communities over the next 30 months with those born in a fourth community, where the young children had not benefited from the community interventions. For more advanced tooth decay the impact was smaller but nevertheless substantial. Children in intervention communities had 34 to 44 percent fewer cavities than those in the comparison community,” per Dr. Maupomé, who went on to say ”These Pacific Northwest tribes consider water a sacred drink so tribal elders liked the idea of regaining American Indian values — it was a culturally attractive choice.”

Co-authors of the study are Njeri Karanja, Ph.D. of the Kaiser Permanente Center for Health Research; Cheryl Ritenbaugh, Ph.D., and Mikel Aickin, Ph.D., of the University of Arizona; Tam Lutz, MPH, of the Northwest Portland Area Indian Health Board; and Thomas Becker, Ph.D., of Oregon Health and Sciences University.

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