AAP Urges Pediatricians to Address Native American Dental Disease Crisis; Indigenous Kids 5 Times More Likely to Get Cavities

Native American and Canadian Indigenous children are experiencing a health crisis of dental disease. In these communities, children are five times more likely than the general U.S. child population to have dental disease, according to a 2014 Indian Health Service survey, and they have five times as many decayed or filled teeth (on average 5.8 in children ages 2 to 5). A new AAP policy statement, “Early Childhood Caries in Indigenous Communities,” in the June 2021 Pediatrics (published online May 17), updates the AAP’s 2011 recommendations, offering treatment guidance and urgency to address this dental health crisis. In many Indigenous communities, dental disease can be found in 90% of young children, ages 3-5, which means that there is much more oral surgery required— 7 times more in children from communities with a high proportion of Indigenous peoples. In remote Indigenous regions of Canada, dental surgery rates are 15 times higher than average, and 73% of Alaska Native children have undergone dental surgery, which is at least 50 times above average. The reasons range from mouth microbiome, diet and poverty to less access to community fluoridated water, fewer dentists and early eruption of teeth in Indigenous children. The policy urges early preventive efforts before age 2, connecting each child in these communities to a dentist by age 1 and new preventions and treatments such as silver diamine fluoride and tooth sealants. Additionally, Native American parents are urged to start brushing baby teeth as soon as they emerge.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.