NTI wants action on poor dental care in Nunavut

Larger communities in Nunavut generally have better access than smaller communities to dental care. Dentist Malcolm Crozier and hygienist Ethel Bailey, shown here in 2010 checking out a patient’s teeth, spend 12 days a month in Cambridge Bay. (PHOTO BY JANE GEORGE)

Tooth decay is “the number one chronic disease” among Inuit, says a new survey on the state of oral health in Inuit communities.

The Inuit Oral Health Survey 2008-2009 found that tooth decay, a chronic, but preventable disease, is two to three times worse among Inuit than among average Canadians.

The release of this survey, which looked into the mouths of more than 1,200 Inuit, prompted a call from Nunavut Tunngavik Inc. for more dental services and better oral health programs in Nunavut.

“Oral health is a strong indicator of overall health, and the results from this survey show an unacceptable reality. More needs to be done to provide dental services for Inuit, and to work with government on prevention and promotion programs in the area of oral health,” NTI president Towtongie said in a May 18 news release.

Compared to southern Canadians, more Inuit report poor oral health and more Inuit — about one in three — must avoid eating certain foods due to the sad state of their teeth and gums. Many are also in pain, the survey found.

“The oral health of Inuit continued to be worse than the archeological findings and validates the findings of earlier Canadian surveys that they bear a disproportionate burden of oral health diseases,” says the survey.

The survey determined that Inuit have more rotten teeth, which need treatment, but that fewer teeth receive treatment. More are pulled, and that means more Inuit end up with no teeth. This means many can’t eat a nutritious diet or even talk well.

Counts of decayed, missing, or filled permanent teeth increased at every age and more are treated by extractions, that is, pulling teeth, among Inuit than southern Canadians, the survey found.

There are 20 times more extractions among young Inuit and six times more for adult Inuit than among southern Canadians.

All this teeth-pulling has a consequence: by age 40, one in five Inuit have no teeth. Many others have fewer than the full number of 28 teeth.

Among Inuit adults who do keep their teeth, about four in 10 had fewer than 21 teeth.

The average number of teeth left, only about 15, also shows Inuit have “less adequate dentitions than southern Canadians,” the survey says.

Only one in two Inuit made a visit for dental care during a 12-month period before the survey, even although very few said cost was a factor in avoiding visiting or accepting recommended dental treatment.

That’s because Health Canada’s Non-insured Health Benefits Program provides medical goods, and services to all Inuit, including drugs, dental care, vision care, medical supplies, and transportation to access medical services.

But although Inuit receive free dental care under the NHIB, many still lack access dental services and prevention programs, Towtongie points out.

“NTI believes that made-in-Nunavut solutions is what’s required to address the disparities in Inuit oral health,” Towtongie said.

The survey also said the high rates of tobacco use, crowded housing and food insecurity which affect overall health also affect oral health.

These need to be addressed for the preventive dental efforts to have “maximal effect,” the survey says.

The Inuit Oral Health Survey was led by the Office of the Chief Dental Officer, Health Canada, in partnership with Inuit Tapiriit Kanatami, the National Inuit Committee on Health and three of the four Inuit regions.

For the survey, trained dentist-examiners examined 1,216 Inuit, 705 females and 511 males, from age three up in the Inuvialuit region, Nunavut and Nunatsiavut.

The survey also found:

• More than eight in 10 Inuit preschoolers had cavities, with about eight of their teeth affected;

• Counts of decayed, missing or filled permanent teeth increased at every age; and,

• Inuit children in the Inuvialuit Region and Inuit children living outside Inuit Nunaat were the most likely to have received dental care in the past year.

On the positive side, the survey found that nearly four in 10 Inuit say they floss their teeth— that’s more than other Canadians say they do.

As well, the number of Inuit adults with no teeth has decreased since 1993 and the treatment of kids with decayed teeth has improved.

You can read a bilingual summary of the survey here:

Summary Sommaire Eng