A review of the oral health of American Indian and Alaska Native elders

Objectives: This paper reviews the demographics,access to care barriers, an d the oral health of American Indian and Alaska Native (Native American) el ders aged 65 years and older using complete tooth loss as a measure to comp are with the US population. Strategies for improving oral health and increa sing access to care for Native American elders also are discussed. Methods: We reviewed the results from patient surveys conducted by the Indian Healt h Service (1983-84 and 1991) and data from other sources, including the sec ond International Collaborative Study of Oral Health Outcomes (ICS-II) cond ucted in 1990 on the Sioux and Navajo reservations. We compared complete to oth loss data from these studies with findings of the 1985 National institu te of Dental Research Oral Health Survey of US Employed Adults and Seniors and the Third National Health and Nutrition Examination Survey (NHANES III) . Results: The 1991 Indian Health Service (IHS) patient survey reported a c omplete tooth loss prevalence of 42 percent among elders. Although it is ba sed on a patient sample, this finding is comparable to the rate of 40 perce nt found among a random sample of Navajo and Lakota adults aged 65-74 years reported in the ICS-II study. The 1991 IHS patient survey also found compl ete tooth loss among diabetics to be much higher than among nondiabetics. C onclusions: The prevalence of complete tooth loss for Native American elder s is higher than in population surveys of US elders based on random samples . The actual prevalence of complete tooth loss is probably even higher in N ative American elders because estimates presented in this paper are clinic based.