Program roots out cultural causes of tooth decay

"No cavities!" is the good news children and parents are hearing more often these days. But for children from some cultural groups, the news isn't so good.

The Lower Mainland's first culturally specific oral health promotion project, headed by Dr. Rosamund Harrison, chair of UBC's Pediatric Dentistry division, aims to address the problem.

"Healthy Teeth, Happy Children" is targeted to Vietnamese toddlers, for whom dental problems often begin with nursing decay-- a severe and extensive form of tooth decay linked to inappropriate infant feeding and comforting habits.

Sixty Vietnamese mothers of young children were interviewed in their own language on topics ranging from bottle feeding to attitudes toward dental health services. The children's teeth were checked by the project's hygienist.

The findings showed the children had severe dental disease compared to the general child population. Harrison says there were a number of causes.

"Many of these mothers had to stop breast feeding earlier than recommended, often because they were single parents needing to go out and work. Also, with little access to education in their own language or extended families to help them, they did not understand the importance of early weaning from the bottle or brushing infants' teeth."

To help mothers learn about the risks of dental decay in young children, individual counselling sessions in Vietnamese were scheduled to coincide with regular immunization visits to Mt. Pleasant Health Clinic. Over 40 counselling mornings were held.

The Vancouver Richmond Health Board (VRHB) provided facilities and translation services and produced a video with the project team. The video, Preventing Tooth Decay: Infants and Toddlers, is available in five languages. Over 200 copies of it have been sold so far.

Project staff also made community presentations to Vietnamese parenting groups and presented information in local Vietnamese media.

Yvonne Phung, community dental health worker, worked with the mothers.

"In Vietnam, most people can't afford regular check-ups so you don't go to the dentist until there's a real problem," she says. "Some kids we saw had such bad decay they couldn't eat without pain. We had to challenge some traditional thinking and stress the importance of caring for primary teeth."

Results showed education and counselling in the mother's native language had a significant effect on toddlers' dental health.

The success of the project was due to a variety of factors says Harrison.

"We made it convenient to come in and talk, and we coupled visits with the immunization program so that dental health was seen as being an important part of overall health," she says.

The project was recently recognized as a model of community health education, winning first prize at the Pacific Northwest Dental Conference.