Reducing Oral Health Inequalities between Canadian Aboriginal and Non-Aboriginal Children

The Dental Preventive Program of the Sioux Lookout Zone (SLZ), Ontario aims to impact on the oral health status, health behaviour and use of hospital dental services by its young Aboriginal population through prenatal education, parental counselling and fluoride varnish treatments. Objectives: 1) to describe the decline in caries prevalence in the primary dentition of SLZ children from 2001-2005; 2) to investigate oral health disparities between preschoolers living on reserves and those living off reserve, and between Aboriginal and non-Aboriginal schoolchildren. Methods: Oral health data collected in 2001 and 2005 from random samples of 2-4 year-olds in 20 First Nations (FN) SLZ communities were compared. 460 and 757 children were examined for the dmft/s indices by calibrated dental hygienists. Cross-sectional data for 416 (2003), 687 (2004) and 544 (2005) 4 yr-olds attending Junior Kindergarten (JK) in neighbouring Thunder Bay were collected by calibrated dental hygienists with the District's Health Unit. Results: In 2001, the mean dmft scores (95% confidence interval) of 2-, 3- and 4-year-old FN children in the SLZ were: 9.1 (8.3-9.9), 12.4 (11.8-13.1), 13.1 (12.1-14.2). In 2005, FN children aged 2, 3 and 4 years had a mean dmft of: 6.2 (5.5-6.9), 9.3 (8.7-10.0), 11.3 (10.6-11.9), representing significant reductions in caries prevalence (32%, 25% and 14%). The mean dmft of on-reserve children was significantly higher than off-reserve FN children living in Thunder Bay – 5.9 (4.8-7.1) at age 4. Odds of having caries, adjusted for school's risk level, age, sex, and intra-cluster (school) correlation using GEE, were 5.6-7.8 times higher in Aboriginals than non-Aboriginals. Conclusions: Significant improvements in the oral health status of Aboriginal preschoolers in the SLZ occurred over a 5-yr-period. However, disparities remain between on- and off-reserve and Aboriginal and non-Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities.