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University of Iowa News Release

July 25, 2006

Researchers Collaborate To Improve American Indian Children's Oral Health

Researchers from the University of Iowa Colleges of Public Health and Dentistry are collaborating with the Aberdeen Area Tribal Chairman's Health Board (AATCHB) on a three-year, $1.2 million grant to improve the oral health of Northern Plains Indian children.

Based in Rapid City, S.D., AATCHB provides advocacy and assistance to the 17 tribes of Iowa, Nebraska, North Dakota and South Dakota on health matters. AATCHB received the grant from the National Center for Minority Health and Health Disparities, part of the National Institutes of Health, to support a collaboration between AATCHB and the UI that addresses a critical health issue identified by tribal communities in the region: early childhood tooth decay. The program will be known as the Healthy Smiles Study.

"Among Indian children, tooth decay is the most prevalent and one of the most costly diseases of childhood," said Joe Coulter, Ph.D., UI professor of community and behavioral health and co-principal investigator of the grant. "Almost 80 percent of Indian children between 2 and 5 years of age have tooth decay. This rate is more than three times higher than among the general U.S. population."

A large proportion of tribal children have an aggressive and destructive form of tooth decay called rampant early childhood caries (ECC). Many Northern Plains tribal children require surgery under general anesthesia to repair their decayed teeth. The consequences of tooth decay in young children include pain and infection, and severe decay may affect a child's ability to learn, eat, speak and grow properly.

The overall long-term goal of the Healthy Smiles Study is to develop, test and evaluate innovative, evidence-based models to prevent ECC in Northern Plains tribal communities. An important aspect of the project is that it is based on a principle known as community-based participatory research (CBPR).

"CBPR means that community members, or key stakeholders in the community's health, must be involved in all phases of the research - from development of the research question through communication of the final results," Coulter said. "This process ensures that the research addresses health problems important to the community in a manner that meets the needs of the community rather than the needs of the researchers."

During the first year of the study, the research staff will visit participating communities to meet with community members, tribal leaders and health care providers. Based on information obtained from the community, the researchers will design small-scale projects to improve children's oral health and will present these projects for consideration by the community. The community will then select those projects that they feel are most appropriate for their specific community and will designate a community advisory board to plan, monitor and participate in all aspects of the study.

During the second and third years of the grant, the pilot projects will be implemented. Whenever possible, community members will be hired to conduct the pilot projects under the guidance of the researchers. Special effort will be made to recruit college students from the participating community to give them practical experience in health research. Throughout the study, the community will be kept informed of its progress.

Delores Starr, a registered dental hygienist, Oglala Sioux tribal member and Aberdeen Area ECC prevention officer with the Indian Health Service, chairs the Healthy Smiles Study steering committee, which over sees the entire project.

Other key researchers involved with the project include principal investigator Lawrence Robertson, M.D., Healthy Smiles study director Cecelia Big Crow, Francine Romero, Ph.D. and Dew Marie Bad Warrior, all with the AATCHB. UI researchers include College of Public Health investigator N. Andrew Peterson, Ph.D.; College of Dentistry investigators Deborah Dawson, Ph.D., David Drake, Ph.D., Michael Kanellis, D.D.S., Cindy Marek, Pharm.D., Teresa Marshall, Ph.D., John Warren, D.D.S., and Karin Weber-Gasparoni, D.D.S., Ph.D. Kathy Phipps, Dr.P.H., a private consultant to the AATCHB, is also contributing to the study.

STORY SOURCE: University of Iowa College of Public Health Office of Communications, 4257 Westlawn, Iowa City, Iowa 52242.

MEDIA CONTACT: Debra Venzke, 319-335-9647,

GRAPHIC: The AATCHB logo can be downloaded at