Sugar is rotting Nunavut toddlers’ teeth

The dental therapist in Repulse Bay says rates of decayed, missing or filled teeth in Repulse Bay children are twice as high as she expected.


IQALUIT — The mouth of a 10-month-old baby whose first teeth are already brown and crumbling with decay is a sorry sight indeed.

But it’s something that Catherine Tegumiar, a dental therapist in Repulse Bay, sees all too frequently.

Tooth decay in Nunavut’s toddlers is common, and the culprit is sugar.

Sugar is either found naturally as fructose in juice and lactose in breast milk, or added directly to the Carnation-brand milk that’s commonly given to babies.

When babies feed and end up keeping this sugar in their mouths, their teeth began to decay.

“The cause of early childhood caries is from sucking from a bottle or breast freely,” Tegumiar said. “It’s big problem.”

She recently examined 17 six-year olds in Repulse Bay to check the numbers of their decayed, missing or filled teeth — known as “DMF” teeth.

For this study, she relied on a survey that’s been developed by the World Health Organization and approved by the School of Dental Therapists to measure DMF rates in children’s teeth.

The results even surprised Tegumiar. She found that, on average, 12 of the six-year olds’ 20 baby teeth were, or had been, subject to caries or had already been extracted.

“That is very, very high,” Tegumiar said.

In fact, this level of DMF teeth was almost twice the level reported in a past study of dental health across the North.

Tegumiar said that parents hold the the key to improving dental health, and she always encourages them to brush their young children’s teeth regularly.

Tegumiar also advises wiping off the babies’ gums with a clean cloth after feeding, and never letting them fall asleep on the breast or with a bottle. At night, the danger for decay is highest, because the sugar sits on the babies’ mouths and rots their growing teeth.

She also suggests switching babies to cups as soon as they are able to handle them.

“But it [dental health] doesn’t seem to be a big issue in the community, although it affects most children and also costs the government a lot of money,” Tegumiar said.

She’s now working with the hamlet council to improve the state of the community’s dental health through flouridation.

When flouride, a naturally-found chemical that’s also a by-product of the aluminum industry, is added to water, rates of tooth decay have been found to go down after four to five years.

“What flouride does is help strengthen the teeth,” Tegumiar said.

But in order to have flouridation in Repulse Bay, there has to be a reservoir similar to those that exist in Rankin Inlet and Iqaluit, where the water supply is already flouridated.

Such a reservoir could be constructed at the same time as a new airstrip, if — or when — the community’s request to have its airstrip moved from the centre of town to another location is approved.

“It’s a big investment,” Tegumiar said. “But in the long run it will pay for itself.”

In Repulse Bay, young children in need of extensive dental work must be flown out, at considerable expense, with an escort, to Churchill, Manitoba.

There, they are operated on under general anesthesia, a surgical intervention that itself carries some health risks. The average stay of the young dental patients is two weeks.

Almost all of the children Tegumiar surveyed had already traveled out to Churchill for repair work on their teeth.

Tegumiar, who has lived in Repulse Bay for eight years, said that despite the widespread dental problems in children, the Kivalliq region is extremely short of dental therapists.

Repulse, Arviat, Baker Lake and Rankin Inlet are the only communities with dental therapists.

At present three positions, one in Coral Harbour and two in Rankin Inlet, are vacant. The result is that smaller communities such as Chesterfield Inlet, Whale Cover and Sanikiluaq rarely receive services from a dental therapist.

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