health declines in rural Alaska
Journal of Dental Research: In 1943, researchers determined that the dental health of Alaska Natives was between excellent and perfect, long before water was artificially fluoridated. (Note: 1 mb file)
American Journal of Physical Anthropology: Dental caries almost non-existent in the remains of hundreds of pre-white-contact Alaska Natives from Kodiak Island and Point Hope.
European Journal of Oral Sciences: Caries among Eskimos remained nearly non-existent through the early 1960's, while their diet primarily consisted of protein-rich subsistence foods, prior to: a) adopting a diet rich in "Western foods", with sugars/starches, b) fluoridation programs introduced throughout rural Alaska from the 1960's through early 1990's, and c) the advent of a caries "epidemic" (described below), despite the fluoridation. Epilogue: While fluoridation programs remain active in larger rural villages, fluoridation was suspended in the 115 smallest rural Alaska villages, in the wake of the mid-1990's Hooper Bay fluoride poisoning incident.
American Dental Association: "Decades of programmatic efforts by Indian Health Service (IHS) and tribal health programs - including community water system fluoridation... have resulted in little or no long term improvement in early childhood caries (ECC) prevalence or severity. Thus, interventions found effective in preventing ECC in other populations have shown no demonstrable longterm or sustainable benefit in most American Indian/Alaska Native communities." (From 2nd paragraph of the Introduction, Note: 1 mb file)
US Public Health Service: School water supplies should be fluoridated at 4.5 times the level recommended for the community, or up to 6.5 ppm. The 1985 and 1992 "fluoridation censuses" show that schools in Unalaska, St. Michael, Stebbins, and Shismaref fluoridated their water systems at 5.0 ppm! (Note: The entire 42 MB, 1,300+ page source documents for these "fluoridation censuses" can be downloaded here..)
Centers for Disease Control: Children drinking fluoridated water containing at least 0.6 ppm fluoride should be given NO supplemental fluoride! (See Table 1)
EPA: Water systems exceeding 2 ppm fluoride are required to recommend that "consumers use an alternative drinking water source for those under nine years of age", and seek to reduce total fluoride exposure. (See 2nd paragraph, "Background" section)
North Slope dental health called worst in U.S.
Indian Health Service examiners who looked into the mouths of 443 Alaska Natives have concluded that rates of dental disease in the North Slope Borough are the nation's highest.
Examiners reported finding active cavities among Native children aged 3 to 5 at three times the national average.
Nearly 3/4 of the 62 Native elders aged 65 or older had no teeth at all, the dental examiners said.
The rate of elders needing full dentures was higher than that reported on Indian reservations in the rest of the United States.
Dr. Terry H. Vibbert, an IHS dentist in the middle of a two-year assignment at Barrow, said the results would have shocked him had he not already seen abundant evidence of poor oral hygiene.
"I'm originally from Indiana, and when I first came here I was quite a bit alarmed," said Vibbert, who finished dental school just two years ago.
"But these results are not startling to me now. I'd already seen it."
Vibbert said the study disclosed that more Alaska Natives had more decay on more teeth, and involving more surfaces of the teeth, than Americans elsewhere.
The study populations represented 38 percent of the total number of Alaska Natives in the North Slope Borough.
Specialists in epidemiology and dental public health from the Oregon Health Sciences University examined Natives last year in the North Slope government seat at Barrow and three outlying villages - Pt. Hope, Wainwright, and Atqasuk.
Vibbert, who did not accompany the examiners as they flew from village to village, said people were alerted that free dental exams would be available, but no formal screening or recruiting was done beforehand.
He said the chance at a free exam probably did not call out a village's worst cases only.
"This is what I would call a true cross sectional survey. It's not weighted to one side or the other," Vibbert said.
Examiners said 40 percent of elementary students had cavities, and 70 percent had cavities by the time they reached high school.
"Our students have significantly higher decay rates than Native students in Nome or Dillingham," North Slope dentists reported in a borough newsletter.
Vibbert said examiners also questioned Natives about diet but came to no specific recommendations about improving nutrition to cut down on the high rate of decay and tooth loss.
Instead, the health service is borrowing a technique from groups like the American Lung Association, which uses sophisticated programs in the schools to teach very young children the hazards of smoking.
In place of showing cartoons of unhealthy lungs, North Slope dentists are organizing classroom "brush-ins" - daily or weekly sessions where children as young as 5 years old brush their teeth in a group.
Brush-ins are already being tried at Wainwright schools.
"We have all the kids stand up and use fluoride toothpaste and brush their teeth in a group," Vibbert said.
"If the kid next to you is doing it, you'll do it."
Other public education efforts are aimed at adults who are being taught the value of dental sealants - a plastic-like coating - and the virtue of drinking fluoridated water.
Parents also are being told to avoid so-called baby-bottle tooth decay which shows up in children allowed to keep a bottle of sugary liquids pressed up against their front teeth.
Vibbert said examiners
warned against the use of smokeless tobacco, which is widespread among
villagers and has been linked to oral cancer of the soft tissue of the
mouth and gums.