Prevalence and severity of dental caries among American Indians and AlaskaNatives

Objectives: This paper reports findings from the 1991 IHS Patient Oral Heal th Status and Treatment Needs Survey (1991 IHS patient survey) and presents trends in caries among American Indian and Alaska Native (Native American) populations since 1957. Methods: The 1991 IHS patient survey obtained data from approximately 10 percent (25,000) of the dental patients seen annuall y at IHS, tribal, and urban Indian clinics. The results of this survey are compared descriptively with previous surveys conducted by the IHS beginning in 1957. Results: Findings from the 1991 IHS patient survey indicate that Native Americans experience a much higher prevalence of dental caries in th eir primary and permanent dentitions than the general US population. Howeve r, caries rates in Native American children peaked in 1983-84 and have been going down since that time. Conclusions: While progress has been made in p reventing dental caries among Native Americans, the high prevalence and sev erity at all ages in this rapidly growing population have resulted in a lar ge backlog of untreated disease with an overwhelming demand on the resource s available to provide care. Continued emphasis on dental caries prevention and health promotion is an important part of the solution. New strategies such as targeting preventive services toward individuals and groups with th e highest risk of disease and the use of modem conservative treatment metho ds to control disease must be employed Full implementation of these strateg ies and identification of the resources required will depend upon new and o ngoing partnerships among tribes, federal and state governments, and the pr ivate sector.