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Childhood caries steadily declines nationally among American Indians/Alaska Natives

July 01, 2019

By David Burger

Early childhood caries has steadily declined nationally since 2010, and untreated early childhood caries in American Indian/Alaska Native preschool children has “significantly” declined, according to a data brief released June 21 by the Indian Health Service Division of Oral Health.

“The 14% reduction in untreated decay is statistically significant and may be the first measured reduction in decay in this age group ever recorded at a national level,” said Dr. Timothy L. Ricks, assistant surgeon general, chief dental officer of the U.S. Public Health Service and deputy director of the Indian Health Service Division of Oral Health.

Dr. Ricks
The results were published in The Oral Health of American Indian and Alaska Native (AI/AN) Children Aged 1-5 Years:  Results of the 2018-19 IHS Oral Health Survey, available at

Some Indian Health Service areas and programs have had “dramatic, statistically significant reductions” in the prevalence of early childhood caries, Dr. Ricks said. “Not only have we seen a reduction in untreated decay, but we have also seen a reduction in caries experience, and three of the more populous IHS Areas – Navajo, Oklahoma City and Phoenix – have had statistically significant reductions in caries experience ranging from 24% to 45%.”

Dr. Timothy L. Lozon, director of the Indian Health Service Division of Oral Health, said,  “This marks an important milestone for the Indian Health Service dental program and validates the hard work and dedication of thousands of IHS, tribal, and IHS-funded urban dental program staff, and our numerous medical and community partners, over the past decade as part of the IHS Early Childhood Caries Collaborative.  While disparities still exist, the results from this survey show that we are making improvement.”

Dr. Ricks echoed Dr. Lozon’s sentiment.

“We appreciate the private practitioners that provide preventive care and treatment to the American Indian/Alaska Native population,” Dr. Ricks said. “One way we can work together is by understanding and educating member dentists about the significant oral health disparities in the American Indian/Alaska Native population in order to promote and provide evidence-based dental disease prevention to our communities. We continue to promote these best practices as well as newer concepts like silver ion antimicrobials and education materials that are more oral health-literate,” Dr. Ricks said.

The caries collaborative was designed to promote prevention of early childhood caries in young children and was centered around four key concepts: early access to dental care; dental sealant at an early age; fluoride varnish three to four times a year; and interim therapeutic restorations, Dr. Ricks said.

The results are also coupled with some areas that present challenges, Dr. Ricks said. Early childhood caries, however, continues to be a serious health problem for many American Indian/Alaska Native preschool children, despite declining rates, he said. One out of every six one-year-old American Indian/Alaska Native children suffer from early childhood caries, and while almost twice the national level, dental sealants on primary molars in this population may be underutilized, he added.

The 2016-17 data brief on the 6-9 year-old surveillance is also available at That data brief outlined the first measured decrease in caries experience and untreated decay in 6-9 year-old American Indian/Alaska Native children, with dental caries experience dropping from 47% to 30% in this age group since 1999, and untreated dental caries in permanent teeth dropping from 34% to 19% in the same time period.

For more information on the Indian Health Service, an agency within the Department of Health and Human Services responsible for providing federal health services to American Indians and Alaska Natives, visit