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In addition to benefiting from public health programs for all Americans, American Indians and Alaska Natives are eligible for health services from the Indian Health Service (IHS), U.S. Public Health Service. Indian Health Service provides comprehensive health services, including nutrition and dietetics, to American Indians and Alaska Natives living on or near federal Indian reservations or in traditional Indian territory, such as Oklahoma and Alaska. Dramatic improvements have occurred in the health of native Americans since IHS was transferred to the Public Health Service in 1955. Infant mortality rate, maternal deaths, and deaths related to infectious diseases have all decreased. Chronic diseases are now major causes of death. Nutritional factors contribute to at least 4 of the 10 leading causes of American Indian and Alaska Native deaths--heart disease, cancer, cirrhosis, and diabetes--and to the prevalence of overweight, obesity, hypertension, and dental caries. There is still incomplete information on nutritional status and present dietary patterns, nutritive values of native foods, and nutrition education knowledge of the population. Priority nutrition objectives have been developed to address those issues.
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PMID:Nutrition in American Indian health: past, present, and future. 353 63

Oral diseases seem to be the most common health problem of seafarers world-wide. Seafaring as an occupation may create a risk for the dental health of crews of ships. Sitting in messrooms and eating snacks in between regular meals is a popular way of spending free time during the ships voyage. This means not only high caloric intake which contributes to overweight but also to high dental caries incidence among crews. During long sea voyages, the access of seamen to dental services is very limited and making regular check ups and treatment of caries is difficult. The best solution to the problem of poor teeth is a preventive one. Conventional methods for preventing caries are health education, restrictions the use of sugar-containing products, good oral hygiene and use of fluorides. A newer method to prevent caries is systematic use of xylitol. Scientific evidence shows that the addition of small quantities of xylitol, a natural carbohydrate sweetener, to the diet causes a significant reduction in the incidence of dental caries.
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PMID:Xylitol for messrooms--a method worth trying to prevent caries among seafarers. 959 Nov 54

Scientific knowledge concerning effective preventive measures to preserve and protect the health of the public continues to grow exponentially. Methods for assessing the impact of population-based interventions such as policies and laws have also greatly increased in the past decade, including systematic approaches that allow general findings to be drawn from various studies, especially those developed as part of the Guide to Community Preventive Services (Community Guide). However, the translation of the collected scientific evidence gathered to date has been spotty and problematic. Success stories do exist, including community water fluoridation, a significant factor in improvements in reduction of tooth decay over the past 50 years. Even for interventions with a strong science base, such as community water fluoridation, significant barriers to implementation of effective strategies discovered through research remain. Barriers include public misunderstanding of health issues and proposed solutions such as fluoridation; lack of engagement on the part of the media in communicating known effective strategies; and reluctance on the part of policymakers to champion approaches that concern but may not be advocated by their constituencies. The increasing burden of chronic disease places public policymakers into non-traditional roles, such as advocating behavior change as a preventive measure. Science is a critical tool to help legislators and policymakers "connect the dots" between public policies. For example, the elimination or degrading of physical education programs in schools is an important factor in addressing the national epidemic of childhood overweight and obesity in addition to the increase in rates of Type II diabetes among children. This article provides an overview of the past, present, and future associated with translating science into public health policy and law, including a review of tools and strategies to address existing and expanding public health challenges. The article also provides and discusses examples of translating and implementing science-based solutions to address public health problems effectively.
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PMID:How do we translate science into public health policy and law? 1250 98

This statement is intended to inform pediatricians and other health care professionals, parents, superintendents, and school board members about nutritional concerns regarding soft drink consumption in schools. Potential health problems associated with high intake of sweetened drinks are 1) overweight or obesity attributable to additional calories in the diet; 2) displacement of milk consumption, resulting in calcium deficiency with an attendant risk of osteoporosis and fractures; and 3) dental caries and potential enamel erosion. Contracts with school districts for exclusive soft drink rights encourage consumption directly and indirectly. School officials and parents need to become well informed about the health implications of vended drinks in school before making a decision about student access to them. A clearly defined, district-wide policy that restricts the sale of soft drinks will safeguard against health problems as a result of overconsumption.
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PMID:Soft drinks in schools. 1470 69

This paper is intended to demonstrate to nutritionists, dietitians, paediatricians and other health care professionals as well as parents, primary and secondary school authorities, nutritional concerns pertaining to the consumption of soft drinks. High intake of soft drinks is associated with: 1) overweight or obesity because of the intake of additional calories in the diet; 2) increased risk of osteoporosis due to displacement of milk consumption, resulting in calcium deficiency and subsequent bone resorption; and 3) increased risk of dental caries and potential enamel erosion. School officials and parents should be aware of the health implications of vended drinks in schools before making a decision about pupils' and students' access to them.
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PMID:The role of the consumption of beverages in the obesity epidemic. 1592 Sep 26

The aim of this study was to examine the relationship between dietary patterns and caries experience in a representative group of low-income African-American adults. Participants were residents of Detroit, Michigan, with household incomes below 250% of the federally-established poverty level (n = 1,021). Dietary histories were obtained by trained interviewers in face-to-face interviews with the adult participants, using the Block 98.2 food frequency questionnaire. Caries was measured by the ICDAS criteria (International Caries Detection and Assessment System). There were 200 dietary records whose data were judged to be invalid; these participants were omitted from the dietary analyses to leave n = 821. Factor analysis identified patterns of liquid and solid food consumption, and the resulting factor scores were used as covariates in multivariable linear regression. Caries was extensive, with 82.3% of the 1,021 participants (n = 839) having at least one cavitated lesion. Nearly three quarters of the adult participants were overweight or obese. This population had severe caries, poor oral hygiene, and diets that are high in sugars and fats and low in fruits and vegetables. Apart from tap water, the most frequently consumed food item by adults of all ages was soft drinks; 19% of all energy from sugar came from soft drinks alone. In both the bivariate analyses and in the regression model, frequency of soft drink consumption and the presence of gingival plaque deposits were significantly associated with caries. Interventions to promote oral health are unlikely to be successful without improvements in the social and physical environment.
Caries Res 2006
PMID:Dietary patterns related to caries in a low-income adult population. 1815 86

Inappropriate baby bottle use is associated with tooth decay, anemia, and overweight, and it may adversely affect dietary patterns. Parents often do not follow guidance to wean by 18 months of life. We piloted a brief, counseling-based weaning intervention in an urban WIC agency among primarily Hispanic parent/toddler dyads. At baseline (n = 48), toddlers consumed a mean 4.7 bottles/day. At follow-up (n = 39), the intervention group consumed fewer mean bottles/day than controls (0.09 vs 2.0 bottles/day, P < .045). Half the toddlers in the experimental group and one third of the control groups weaned completely. Parents of weaned children were satisfied with the outcome.
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PMID:Randomized controlled trial of bottle weaning intervention: a pilot study. 1732 91

Obesity in the young is a public health priority. The prevalence of overweight children in the United States has risen almost threefold in the last two decades. An association between weight and oral health has been suggested in adults, whereas evidence supporting this association in children is controversial at best. The aim of our study was to evaluate the association between weight and dental caries in a random prospective cohort of children at their initial visit at an urban dental school. One hundred and thirty-five children were recruited in a four-month period. The DS/ds index was used to assess caries, and BMI percentile was calculated based on age and gender-adjusted published scales. Correlation analyses, linear, and multivariate regression including age, gender, and BMI were calculated with a significance threshold of p>0.05. No correlation between dental decay in obese and non-obese children was detected (p=0.99). These findings support recent U.S. population-based literature that reports an inverse association between caries and weight in certain pediatric groups. Nevertheless, the impact of interventions to address the epidemic in the dental setting has not been investigated. As part of a health care team, dental students should be exposed to the changing demographics and sequelae of overweight in children.
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PMID:Is there an association between weight and dental caries among pediatric patients in an urban dental school? A correlation study. 1797 73

Dental caries is still a common disease among children and adolescents. The aims of the present thesis were therefore: 1) to investigate the approximal caries prevalence in posterior teeth in 15-year-olds, 2) to study past caries experience in the primary dentition in relation to future caries development and need for treatment, 3) to investigate factors during early childhood which are associated with caries development later in life, and 4) to study the association between age-specific body mass index (isoBMI) and approximal caries status in 15-year-olds. Paper I has a retrospective design and the analyses were based on record data from a randomly selected sample. Papers II, III and IV are based on radiographic analyses of posterior teeth in 15-year-olds followed longitudinally from 1 to 15 years of age. The data for these studies were selected from examinations, interviews and questionnaires from early childhood and school health care records at 15 years (isoBMI values). The result showed that the approximal caries prevalence in 15-year-olds is underestimated in official caries data, since initial caries lesions are not included in these statistics. Two thirds of all 15-year-olds had approximal caries and initial caries constituted 86% of the total number of caries lesions. There was a strong relationship between caries in early childhood and approximal caries prevalence in the posterior teeth at 15 years of age. Children with caries experience at 6 years received significantly more treatment in the primary dentition during the period from 7 to 12 years compared with children who were caries free at the same age. Further, it was pointed out that parents' attitudes to dental health and psychosocial factors during early childhood have an effect on approximal caries in 15-year-olds. Additionally, plaque on primary incisors at 1 year of age and infrequent toothbrushing at 3 years of age were associated with a high caries experience at 15 years. It was also demonstrated that adolescents with overweight and obesity had a significantly higher approximal caries prevalence than those of normal weight. Furthermore, it was shown that children's unfavourable snacking habits at 1 and 3 years of age were associated with approximal caries at 15 years. The main conclusions from this thesis are that: 1) epidemiologicalcaries data should include initial caries lesions on approximal tooth surfaces, in order to show the actual caries prevalence, 2) there is a strong relationship between caries in early childhood and approximal caries prevalence in the posterior teeth at 15 years of age, 3) the psychosocial environment in which children live during their childhood has an impact on dental health later in life, 4) good oral hygiene habits including the use of fluoride toothpaste, established in early childhood, provide a foundation for good dental health in adolescence, and 5) future preventive programmes should include, at a multidisciplinary level, strategies to prevent and reduce both dental caries and obesity at an early age.
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PMID:On dental caries and caries-related factors in children and teenagers. 1863 15

This cross-sectional study assessed associations between nutrition and dental caries in permanent dentition and identified oral hygiene indicators among older children aged 12-14 years in primary schools in Thailand. The study was comprised of 862 schoolchildren from five provinces representing five regions of Thailand, from both rural and urban areas, including Bangkok. The dental hygeine status was assessed by evaluating for decayed teeth, missing teeth due to decay, and filled teeth index (DMFT index). Weight and height were measured to evaluate the nutritional status; hygiene practices assessed by interview. The results show a negative relationship between nutritional status and the DMFT index, which increased when the nutritional status decreased (Spearman's rho correlation = -0.140, p < 0.001). The results from multiple logistic regression analysis showed normal weight and thin schoolchildren were more likely to have a DMFT of at least 1 by 1.94 times (OR = 1.94; 95%CI = 1.25-3.00, p = 0.004) and 2.22 times (OR = 2.22; 95%CI = 1.20-4.09, p = 0.001), respectively, compared to overweight and obese children. Normal and thin schoolchildren had a higher risk for dental caries than overweight and obese children aged 12-14 years in Thailand. School health promotion activities should emphasize eating habit improvement in order to reduce the incidence of caries.
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PMID:Association between nutritional status and dental caries in permanent dentition among primary schoolchildren aged 12-14 years, Thailand. 1932 20


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