Among Native Americans, tooth decay wasn’t too common before the arrival of the Europeans. Young people seldom suffered from it: it was usually associated with aging. But this all changed once the Europeans introduced white sugar and other non-indigenous foods. In general, as Weston Price showed, when communities switch from native to Western style diets, dental problems follow.
Recently, I read news of a study that looked at ways of reducing tooth decay (as well as obesity) among young Native Americans by discouraging soda consumption and increasing water intake. Of course, soda – which we might just as well call “sugar water” or “liquid candy” – is one of the prime accelerators of tooth decay in many communities. Not only do soft drinks bathe the teeth and gums in sugar – a favorite food of the oral microbes whose acidic waste products cause tooth decay. The acids they contain also weaken tooth enamel, making the teeth even more vulnerable to cavities.
For the Ethnicity & Disease study, the research team designed an intervention to encourage more healthful behaviors among members of a few Native American communities.
To implement TOTS (“The Toddler Overweight and Tooth Decay Prevention Study”) the researchers worked closely with tribal councils. In three of the four communities, good tasting water was made readily available in water fountains and inexpensive, refillable gallon jugs. Sugared soda was removed from tribal stores, and substitution of water for soda was actively encouraged through community outreach programs. Families received food counseling and breastfeeding support through tribal community health workers.
“After the successful switch to water, we compared the rate of tooth decay in children born in these three communities over the next 30 months with those born in a fourth community, where the young children had not benefited from the community interventions. We found a decrease of between 30 and 63 percent in early stage, potentially reversible tooth decay. For more advanced tooth decay the impact was smaller but nevertheless substantial. Children in intervention communities had 34 to 44 percent fewer cavities than those in the comparison community,” said Gerardo Maupomé, B.D.S., M.Sc., Ph.D., professor of preventive and community dentistry at the Indiana University School of Dentistry and a Regenstrief Institute affiliated scientist. He is the first author of the study.
One of the things that caught my attention here was just how clearly this study shows how healthier environments can encourage healthier behaviors. This is, of course, the thinking behind initiatives to get sodas, sports drinks and other sugary beverages out of schools. Yet these may have only a minor effect. After all, the larger environment remains unchanged. A student who can’t buy soda at school can still buy it away from school and lives in a culture in which drinking soda is the norm.
Yet we can still take steps to create and maintain positive, healthful personal environments for ourselves. And maybe our choices can serve to inspire and motivate others to value and pursue true health – something so much more profound than just the mere avoidance of sickness.
Image by Nicholas Taylor, via Flickr