Aboriginal Children That Contribute To Risk Factors For Early Childhood Caries

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Introduction By evaluating underlying aboriginal community components that contribute to risk factors for early childhood caries (ECC) several solutions for improved child oral health can be achieved. Advocacy for community water fluoridation and fluoride varnish program access is crucial for the prevention of ECC. Also, increased resources and opportunity for community based oral health initiatives will help prevent aboriginal oral health disparities. Lack of oral health education in Aboriginal communities contributes to poor child oral health practices. There are few organized culturally sensitive preventative educational opportunities for aboriginal citizens to learn more about child oral health issues. The effect of preventative education for mothers and subsequent caries development in their infants was tested in a Swedish group. Mothers of infants age 6, 12 and 24 months of age were provided diet and oral hygiene counseling, along with fluoride supplements. The study observed a 65% lower caries rate in infants of mothers who had received counseling compared to the control group.1 In Aboriginal communities the health unit could be the resource to deliver preventative information. As Mourdian2 states, “in some communities it may be that dental care would be best provided in these settings” (p 1178). Also by providing services in alternative settings, dental hygienists can form connections and engage other stakeholders or medical professionals to assists in ensuring all aboriginal children receive access to oral health care. As stated by Edelstein3 “Children with special health needs require additional oral health promotion efforts by pediatricians, if poor oral health and significant oral health disparities are to be eliminated” (p. 1187). By linking up the communication process between dental and public health workers, there is opportunity to assure a heightened perception of oral health.

Key Issues to Fluoridation Interventions in Aboriginal Communities Educational programs in aboriginal populations must begin within the first year of the children’s lives to prevent caries from becoming too advanced and being unable to avoid painful problems and expenses. There is evidence that intensive motivational patient counseling with caregivers to change specific behaviors may reduce caries prevalence in their children.1 Good oral hygiene, promotion of healthy snacking and fluoride treatment must be the main goals for prevention of ECC in aboriginal children. In a health unit setting healthcare staff could be provided with educational pamphlets and fluoride supplements to distribute to caregivers in the community. If early intervention could be increased then it will lead to fewer cases of restorative or surgical dental visits and a decreased financial burden on government and individuals. McKay, Leck, Lucas, Carr & Clark4 note, “children affected by ECC means that treatment for this condition often requires general anesthesia, which is costly and involves potential health risks as well as emotional trauma” (p. 4). A significant number of aboriginal children also require repeat dental procedures under general anesthesia.5 In a position statement from the Canadian Pediatric Society5 it is reported, “in some Indigenous communities, the prevalence of ECC exceeds 90%” (p. 352). This statistic provides evidence for a fluoridation prevention program within these communities. Since the first experience of dental treatment for many aboriginal children is only for decay rather than prevention, dental professionals find a barrier to the delivery of fluoride varnish.5 One solution to this problem is the delivery of fluoride varnish and prevention education at medical check-ups or health unit immunization visits. Dental screenings and application of FV can easily be incorporated into busy medical practices, but effective and appropriate involvement of primary care clinicians and nurses or aids can be
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