Long-term effects of a toddler-focused caries prevention programme among Northwestern US tribal children: The TOTS-to-Tweens study.

OBJECTIVES: We sought to determine whether American Indian tribe-based interventions that successfully prevented toddler dental caries in a 2005 cohort study (the Toddler Overweight and Tooth Decay Prevention Study, or TOTS) influenced the prevalence of dental caries in children ages 11 to 13 in the same communities ten years later (the TOTS-to-Tweens study). METHODS: We recruited original TOTS participants and conducted school- and community-based dental screenings at tribal communities that received family plus community-wide interventions (F + CW), community interventions only (CW) or were control communities. We also enrolled children who did not participate in TOTS, but were exposed to CW interventions or to the control environment. Trained clinicians examined children's teeth and recorded whether each tooth was decayed, missing or filled (DMFT). We calculated DMFT scores for each child and evaluated differences in DMFT incidence rate ratios (IRR) and components of DMFT by intervention group. RESULTS: We observed lower age- and sex-adjusted DMFT scores among F + CW children (a mean of 2.1 DMFT; 95% confidence interval [CI]: 1.4-2.7) and among CW children (2.2; 95% CI: 1.9-2.6), than control children (3.0; 95% CI: 2.3-3.7). The F + CW group had 32% lower DMFT scores than control children (IRR = 0.68; 95% CI: 0.46-1.01), and CW children had 26% lower DMFT scores than control (IRR = 0.74; 95% CI: 0.55-1.00). The proportion of children with filled teeth was higher in control than intervention communities (37.9% in F + CW, 47.1% in CW, and 67.1% in control, P = .002). CONCLUSIONS: Our findings suggest modest yet significant long-term effects of interventions that prevented toddler dental caries on the DMFT scores of tweens evaluated ten years later. Further study of effective interventions and their sustainability is clearly warranted among tribal children, who remain at high risk for dental caries.

A dental hygienist who's A Lakota Sioux calls for new mid-level dental providers.

High rates of tooth decay and gum disease plague her native Pine Ridge Indian Reservation, along with the rest of Indian Country.

A model minority faculty fellowship program: enhancing minority faculty in health professions and reducing inequity in health services.

Northern Arizona University (NAU), College of Health and Human Services model Minority Faculty Fellowship Program (MFFP) supports a minority faculty member and strengthens the College without adding to the workload or placing additional strain on an already limited budget. In 2003, the College was awarded a MFFP through the U.S. Department of Health, Health Resources and Services Administration. The College received a second Fellowship in 2008, the only one funded in the country. This three-year Fellowship is aimed at providing minority individuals with the training and skills necessary to flourish in a tenure-track position. There is a shortage of minority faculty in the health professions. Northern Arizona University and the surrounding communities have diverse populations nonetheless, only a very small percentage of faculty at the University are from diverse backgrounds. Success of the NAU, MFFP is largely due to our ability to draw upon existing structures including the University mission and institutional commitment to serving Native Americans, as well as the promotion and tenure process, faculty support programs, and a long-term relationship with the John and Sophie Ottens Foundation. The progress of the current NAU fellowship can also be attributed to the first Fellow's engagement with her contemporary.