ITK calls for action on Inuit oral health

Inuit Tapiriit Kanatami has released its action plan with suggestions for improving oral health.

Inuit Tapiriit Kanatami wants to bridge the oral health disparity between Inuit and other Canadians with its new Inuit Oral Health Action Plan, released this week.

“Healthy Teeth, Healthy Lives: Inuit Oral Health Action Plan 2013” follows the Inuit Oral Health Survey 2008-2009.

That survey found tooth decay, a chronic, but preventable disease, is two to three times worse among Inuit than among average Canadians.

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, the survey said.

Among its goals for improved oral health among Inuit, ITK wants Inuit children to reach the World Health Organization’s goal of 50 per cent of children entering school without a cavity. Right now the average preschooler has about eight cavities.

Overall, ITK wants to see more oral disease prevention, more health promotion and treatment and the reduction of practices such as extractions as the preferred treatment alternative for diseased teeth.

ITK also wants to increase awareness of oral health and its link to better health and more supports offered to families to help them achieve better oral health outcomes.

Among the actions ITK suggests: mobilizing adolescents to improve oral hygiene, increasing the number of Inuit oral health service providers and encouraging better use and access to nutritional foods.

The plan notes poor oral health is linked to an increasing number of diseases.

Cavities and gum disease may contribute to many serious conditions, such as diabetes, cardiovascular and respiratory diseases.

Untreated cavities can also be painful and can lead to serious infections, and are linked to heart disease and pre-term low birth weight babies, the plan says.

And, in rare cases, bacteria from the mouth can enter the blood stream and lead to strokes in infants.

Substance abuse and smoking can lead to unhealthy oral conditions including chronic pain, periodontal disease and oral and throat cancers.

“Ensuring that there is an increased understanding that a healthy mouth and teeth can lead to better overall health must be a message that is integrated in to all public health initiatives,” ITK said.

ITK would like to see “a social marketing campaign that emphasizes the value of healthy teeth and mouths for all Inuit.”

Good oral health should also be part of the overall public health agenda, including it in outreach to such community-based activities as seniors’ lunches, home and community care assessments, well-baby clinics, preschool health checks, and activities under the Canada Prenatal Nutrition Program, ITK said.

Other actions include putting health promotion within the education curriculum for all ages and promoting oral health as a part of overall good health — as is already done in Nunavik where children regularly brush their teeth at child care centres and schools.

Smoking cessation programs should also include the link to healthy teeth and mouths.

The members of the Inuit Public Health Task Group also noted that any measures that can be provided on a public health basis (such as fluoride in drinking water, where possible) are most effective.

In Nunavut dental therapists are salaried employees of the Government of Nunavut through the Department of Health. Of the 26 communities in Nunavut, 17 have positions for dental therapists, few of which are filled. Dentists are contracted by the Government of Nunavut and operate on a fee-for-service basis.

Dentists are reimbursed on a fee-for-service basis (direct billings) through the Health Canada’s Non-Insured Health Benefits Program.

The Nunavik Regional Board of Health and Social Services employs seven dentists: four are hired by the Inuulitsivik Health Centre, serving the Hudson Coast and three by the Tulattavik Health Centre, serving the Ungava Coast.

Salaries for these dentists are paid by the Régie de l’assurance maladie du Québec, while the fees for dental care are received as part of a block payment for all health care under the James Bay and Northern Quebec Agreement.

Salaries of dentists are competitive and positions are readily filled, ITK noted. Dentists operate out of the local community service centres that are located in each Nunavik community.

But dental therapists cannot be licensed in Québec and do not practice in Nunavik.

And, although dental hygienists play a primary role in prevention and promotion of good oral habits, it has been difficult to recruit and retain them.