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Oral Health Disease Takes a Heavy Toll on Children, Adults

This article was produced and provided by the W.K. Kellogg Foundation.

New studies at Pine Ridge, Santo Domingo Pueblo, reveal startling rates of tooth decay

It is clear that oral disease exacts a far heavier toll on children in Indian Country than on children in other parts of the United States. Tooth decay is five times higher among Native American children ages 2 to 4 than the U.S. average. Seventy-two percent of American Indian and Alaska Native children ages 6 to 8 have untreated cavities—more than twice the rate of the general population. What is also becoming clear, however, is that while Native American children suffer a disproportionate share of tooth decay, Native American adults may be the worst-off of all.

Courtesy Kauffman

A dental screening at Santo Domingo Pueblo

In 2011, Terry Batliner, D.D.S., of the Colorado School of Public Health and the Cherokee Nation of Oklahoma, conducted an oral health survey of the Pine Ridge Indian Reservation in South Dakota. Forty percent of children and nearly 60 percent of adults had moderate to urgent dental needs. Batliner and his research team also discovered that 84 percent of children in the study and 97 percent of adults had ongoing decay, which can lead to loss of permanent teeth. The Pine Ridge study also found high rates of precancerous conditions, chronic pain and missing teeth.

Just a few months ago, Batliner conducted a similar assessment of the Santo Domingo Pueblo (also known as the Kewa Pueblo) in New Mexico. Nearly 70 percent of adults ages 20 to 64 had untreated cavities, and nearly half of adults ages 45 to 64 suffered from moderate or significant gum disease.

Courtesy Kauffman

Terry Batliner

“In certain locations we have very high rates of tooth decay, as bad as anywhere in the world,” he said. Despite efforts to address the problem, there is “not enough manpower, and not enough dentists, to provide the preventive care that could make a difference,” he added.

The Indian Health Service, which is responsible for providing oral health care to American Indians and Alaska Natives, in recent years has prioritized care for children. This has helped improve access for American Indian children somewhat, but adults are still gravely underserved because of severe dental care shortages in Indian Country.

“There are good dentists doing everything they can to help,” Batliner said. “But there are not enough of them, and the level of disease is overwhelming. Things like abscesses that would be considered a dental emergency anywhere else are not considered emergencies here but conditions that people must endure.”

Dental therapists hold great promise for Indian Country.

“I have seen dental therapists at work providing excellent care. And they are invested in the people and the community,” says Batliner. “We cannot let children and adults on reservations suffer to the point where an easily treatable dental problem becomes life-threatening. I have seen it too many times.