Healthy Teeth, Healthy Lives: Steps to Improve Inuit Children’s Oral Health

Saturday, March 21, 2015

Ottawa, Ontario

Annie Aningmiuq, Department of Health and Social Development

Inuit Tapiriit Kanatami (ITK)

IMICH 2015:

Challenging Health Inequities

Disclosure

• Annie Aningmiuq has no relevant financial relationships with the manufacturer(s) of commercial services discussed in this CME activity

• Annie Aningmiuq does not intend to discuss an unapproved/investigative use of a commercial product/device in this presentation

Inuit Population

• 59,445 Inuit in Canada

• Population increase of 26% from 1996 - 2006

• Median age of 23

• Aboriginal Peoples in Canada: Inuit, First Nations and Métis

Communities

• Inuit live in northern regions of Alaska, Chukotka, Greenland and Canada

• 53 Inuit communities in Canada

• Four Inuit Land Claim Regions • Inuvialuit • Nunavut • Nunavik • Nunatsiavut

• Remote Communities

Inuit

Inuit Culture

• Founded in 1971

• National representative voice / organization for Inuit in Canada

• Represent and promote the interests of Inuit on a wide variety of health, environmental, social, cultural, and political challenges

• Oral Health continues to be a priority

Inuit Tapiriit Kanatami (ITK)

Nunavut Tunngavik

Inc.

Makivik Inuvialuit Regional

Corporation

Nunatsiavut Government

NICoH

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ther In

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Organ

ization

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Inuit Circumpolar

Council

Pauktuutit National

Inuit Youth Council

Department of Health and Social Development

Inuit Public Health Task Group Inuit Food Security Working Group

Alianait Mental Wellness Task Group

Inuit Early Childhood Development Working Group Inuit Maternal Child Health Working Group Inuit Non-Insured Health Benefit Working Group National Inuit Health Survey Working Group

NIC

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National Inuit Human Resource Development Technical Committee O

ther

National Inuit Youth Council

Department of Health and Social Development

Oral Health in Inuit Nunangat

• Access to regular dental care is not consistent due to remote location

• Treatment is often untimely • Insufficient access to prevention • Inadequate funding arrangements • Jurisdictional barriers • Limited access to services • Poor nutrition/access to nutritious

foods • Difficulty in recruiting and retaining

oral health service providers • Language barriers between client and

oral health professionals

Availability of Health Services

0 flights

0h 14 min Distance: 6 km

0 stops

0 overnights

Ottawa

29h 22 min 0h 4 min

29h 0 min

Distance: 1 km

Distance: 1,869 km

Distance: 3,481 km

Paulatuk

Grise Fiord

1 overnight 0 overnights

1 overnight

4 stops

4 stops 0 stops

3 flights

2 flights

0 flights

Iqaluit

Ottawa

Iqaluit

Paulatuk

Grise Fiord

Edmonton

A Patient’s Journey

• The 2008-2009 Inuit Oral Health Survey was conducted by

Health Canada (under Dr. Peter Cooney) in collaboration with

ITK, Nunavut Tunngavik Inc., Nunatsiavut Government, and

Inuvialuit Regional Corporation.

• The Survey found that oral disease is 2 to 3 times that of the

rest of Canada.

• Table 1 shows a comparison of dental carries, and decayed,

missing, or filled teeth (DMFT) as compared to the general

Canadian public.

Inuit Oral Health Survey 2008/09

http://www.hc-sc.gc.ca/fniah-spnia/alt_formats/pdf/pubs/promotion/_oral-bucco/oral-inuit-buccal-eng.pdf

• In response to this oral health crisis, ITK collaborated with two subcommittees of the National Inuit Committee on Health (NICoH):

• Inuit Non-Insured Health Benefits Working Group

• Inuit Public Health Task Group

• Healthy Teeth, Healthy Lives: Inuit

Oral Health Action Plan launched in April 2013

Inuit Oral Health Action Plan

8 Actions for Change

1. Strengthen leadership 2. Link oral health to overall health 3. Increase focus on prevention initiatives 4. Improve access to treatment 5. Engage and mobilize parents and caregivers 6. Engage and mobilize adolescents 7. Encourage Inuit to pursue careers as oral health service providers 8. Improve use of and access to affordable nutritional foods

Action 2 Link Oral Health to Overall Health

• Poor oral health is linked to an increasing number of diseases including diabetes, heart disease and stroke as well as pre-term and low-birth-weight babies (CDA, 2014)

• Substance abuse and smoking can lead to unhealthy oral conditions

• Need to emphasize the message that a healthy mouth and teeth can lead to better overall health – Inuit-specific and culturally appropriate way.

Actions 3 and 4

Improve Treatment • Fluoride

• Good oral health habits

• Education

• Making healthy food choices

• Early intervention techniques

• Early and regular visits to an oral health provider

Increase Prevention • Bring services home

• increase number of Inuit oral health care professionals

• Examine jurisdictional barriers to treatment (dental therapists, etc.)

• Improve access to oral health professionals

• Organized treatment blitz in the North

• Actively implement best practices and remove outdated practices

• Organized regular checkups, starting at the age of one

Recent Successes in Prevention and Treatment in Inuit Nunangat

• Nunavik Oral Health Plan (Nunavik)

• Community launches of IOHAP and treatment blitzes (Nunatsiavut)

• Little Teeth are a Big Deal (Inuvialuit)

• Nunavut Oral Health Project (Nunavut)

• ITK-CDHA collaboration – Inuit-specific pamphlets

• ITK-CDA collaboration – OH Promotion kits

Inuit Oral Health Tips and Activity Sheets

ITK-CDHA collaboration: Inuit-specific handouts

Inuit-specific Oral Health Promotional Kits

• ITK-Canadian Dental Association collaboration

• 10K kits sent all over Inuit Nunangat to encourage Inuit-specific promotion

Actions 5 and 6 Engage and Mobilize Parents/Adolescents

• Key partners in encouraging good oral hygiene practice for their children

• Improve understanding of:

• good oral hygiene

• link between salival bacteria and tooth decay

• importance of healthy baby teeth

• Dangers of General Anaesthetic

• Culturally appropriate awareness/ Social media campaigns

• School-based programs

Closing Thoughts

• Ensure that culturally appropriate oral health messaging is integrated in to all public health initiatives

• Active engagement of Inuit in the development of sustainable solutions

• Ensure Inuit receive quality, timely and culturally- safe dental care and prevention

• Mobilizing parents, care-givers, and adolescents

• Bring it home: Offer greater incentives for oral health professionals practicing in Inuit communities

Solutions to Better Oral Health Outcomes for Inuit Children:

Key Messages To Take Home

• Work with us! – Inuit involvement, respect, commitment to health equity,

transparency, accountability and collaboration.

• Innovative solutions

• Address the root causes – Social Determinants of Health

• Inuit-specific approaches

• Sustainable investment

• Collaboration – We need to work together

Qujannamiik

Annie Aningmiuq aningmiuq@itk.ca