The Aberdeen Area Indian Health Service participated in the International Collaborative Study of Oral Health Outcomes (ICS- 11), coordinated by the World Health Organization (WHO). The study of the oral health status of Native American elders was only a small part of the entire ICS-11 project. Two Indian Reservations located in South Dakota were chosen as the site for the study. The purpose of the study was to assess the oral health status, needed treatment, and the attitudes of American Indians who were 65-74 years of age living in the study area. The study participants were randomly selected from a list of hospital/clinic users, generated by the Public Health Service serving the study site. The sample size was comprised of 688 older Native American Indians selected randomly from the 952 data-base of the Public Health Service. Letters were mailed to these 688 individuals explaining the purpose of the study. In addition, each participant was given an appointment time and date. A database system received all contacts, refusals, deaths, non-contacts, and moves. The study was divided into two parts. Data were collected in the first segment by an interviewer-administered questionnaire. The interviewers were trained bilingual Community Health Representatives. The second segment consisted of an oral examination conducted by a hygienist or a dentist that occurred immediately after the interview. The Michigan Interactive Data Analysis System (MIDAS) generated simple descriptive statistics for each variable. The evaluation of any relationship between the oral health outcomes and the independent variables were calculated by using multiple or logistic regression analyses and the MIDAS. The data collection period was 6 weeks with 204 participants and a final response of 39.6 percent.The sample included 58 % female, cigarette smokers comprised 52.9 % were cigarette smokers, and 97.6 % were reported as American Indian. The majority of those participating in the study did not complete high school and 72.1 % stated they earned a total annual income of less than $10,000. The study revealed that 58.3 % were totally edentulous and only one study participant had all of their teeth. S slight majority of those who were totally edentulous were found to have worn both upper and lower dentures. It was determined that half of those who were edentulous needed new complete dentures and 16 % needed their present dentures repaired. Fifty-three percent of the dentate sample needed at least one extraction with each participant requiring approximately three extractions. When the different categories of need were analyzed together, nearly 74 % of the dentate participants needed at least one treatment with each person on the average requiring almost four services. There were 94 % who reported that they did have a usual dental care source. However, 40 % indicated they had not received any dental care in the last five years. When study participants, not receiving care in the last two years were asked why they didn't seek care, the majority reported either nothing was wrong or that they had no teeth. The reason, something was wrong, was given by those who had seen a dentist in the last two years. Most reported that fluoride was helpful in preventing tooth decay and that tooth decay is caused by eating sweets. They did place great value on the care of their teeth. Sixty-one percent of those edentulous participants believed it was important to keep one's natural teeth. The dentate participants (70.9 %) reported that it was important to keep one's own natural teeth.It was recommended that more data should be collected so that the status of oral health of American Indian elders can be adequately determined. Additional research should be concentrated on why these elders do not seek dental care. The Indian Health Service should conduct public information campaigns as an effort to encourage elders to request and receive the dental services they need. The dentulous population should be targeted by special community based clinics as an effort to draw the adult population in for dental services.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-82).
Phipps KR. Oral health status of Native American elders. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-82). 1989