Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake

Abstract

BackgroundTooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown.ObjectiveTo conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children.DesignBased on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms “Alaska Native”, “children” and “oral health” were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970–2012) for relevant clinical trials and evaluation studies.ResultsEighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children.ConclusionsFew oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising approaches to improve the oral and systemic health of Alaska Native children. Future investigators should evaluate the feasibility of implementing multilevel interventions and policies within Alaska Native communities as a way to reduce children's health disparities.

Intergenerational and Social Interventions to Improve Children’s Oral Health

“…33 Nonetheless, community-centered multilevel interventions to reduce sugar-sweetened beverage intake among Alaska Native children were deemed promising. 33 Another systematic review was conducted on the influence of family environment on children’s oral health.…”

“…33 Nonetheless, community-centered multilevel interventions to reduce sugar-sweetened beverage intake among Alaska Native children were deemed promising. 33 Another systematic review was conducted on the influence of family environment on children’s oral health. 34 The authors concluded that since parents’ dental habits influence their children’s dental habits, special attention should be given to the entire family, not only to prevent oral disease, but to improve quality of life.…”

Improving Children’s Oral Health

“…range from genetic and biological to cultural, behavioral, social, and administrative (Patrick et al, 2006;Fisher-Owens et al, 2007;Chi, 2013;Lee and Divaris, 2014). High-impact research is being conducted at all these levels.…”

Brief Review on Prophylaxis and Treatment of Caries Disease.

“…Other factors that trigger dental caries are poor oral hygiene, frequent ingestion of sugary foods, etc. The main symptoms of caries are acute pain, inflammation, increased sensitivity to food or cold or hot drinks, bad breath and tooth loss [18].…”

“…Thus, the control of the presence of microorganisms in the oral cavity influencing the caries process, or being influenced by organic salivary, immunological and chemotherapeutic factors, should not be considered for the establishment of prevention strategies, and the simple presence of microorganisms in the oral Cavity, whether in saliva or plaque, is not a factor that determines the onset of disease caries [17][18][19][20].…”