Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake

• Published in: International Journal of Circumpolar Health
• Main Author: Donald L. Chi
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2013
• Subjects: oral health disparities; Alaska Native health disparities; dental caries prevention; children; dental workforce; primary intervention in oral health; sugar-sweetened beverages; Arctic medicine. Tropical medicine; RC955-962; Arctic; Prisma; Circumpolar Health; International Journal of Circumpolar Health; Alaska
• Online Access: https://doi.org/10.3402/ijch.v72i0.21066; https://doaj.org/article/25ab17183a2f4e87b7fe05c2919e8e2b

Background. Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. Objective. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children. Design. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms “Alaska Native”, “children” and “oral health” were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970–2012) for relevant clinical trials and evaluation studies. Results. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Conclusions. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions ...