Investigating Native American Dental Health

May 13, 2016

Statistics show that the dental health of young Native Americans is particularly bad compared to other groups. But efforts are underway to find out why.


Native American children have an unusually high rate of tooth decay. The problem is shown in figures for the number of kids that are admitted for dental work in serious office visits that require surgery compared to young people of other demographic groups.

“The rate for the rest of the country overall is less than 4 in 1,000 children. The rate in many Indian communities is greater than 200 per 1,000.  In some communities it is over 500, meaning half the children.”

Dr. Dee Robertson heads the group “QUEST,” which stands for Quantifying, Understanding, and Eliminating Severe Tooth decay in American Indian and Alaska-native children.

Robertson says the reasons behind the problem are complex.  “We're almost sure it’s not genetic. There’s something complex going on, and we know that in the Indian communities where a lot of children have this, if you grow up there--say rather than the suburbs of Spokane--the same child would be at a different risk. But it’s multiple factors, not just a single one.”

Robertson says one approach that has seen some success in treating tooth decay is an older technique using silver nitrate to treat decaying teeth, rather than surgical procedures.

“So if a child comes in with tooth decay, and it’s not too deep, and they don’t have an abscess, the parent is offered the option of, 'We think we can control this with a medication rather than drilling and filling it.'”

Robertson says the vast majority of parents given that option choose to try the medication.

That project, called the Warm Springs Model has been offered through Indian Health Services around our region, but no Washington or Idaho sites requested to be involved. Robertson says popular demand at Indian health service offices could change that.

Dr. Robertson says efforts continue to determine causes and potential ways to prevent the dental issues, including collaboration between dentists and doctors and literally over a hundred projects to study different approaches.