Ka Wai Ola - Office of Hawaiian Affairs, Volume 2, Number 1, 1 January 1985 — He Mau Ninau Ola Some Health Questions [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola Some Health Questions

by Kekuni Blaisdell, M.D. ; • •

Q: All six of my mo'opuna have so many cavities in their teeth, I am going broke paying the dentist's bill. I remember myTutu; she died at 81 with all of her own teeth. She never did go to the dentist. She was too poor. Why the difference in niho (teeth) be-

tween my Tutu and kamali'i (children) these days? What ean I do about these cavities besides pay more dentist's bills? A: Your mo'opuna would appear to support a 1973 report that our po'e Hawai'i (Hawaiian) school children had the highest prevalence of puka-niho (dental caries) compared to the other lahui (races). This large study of 910 eighth-graders was conducted by Dr. Jean Hankin and Dr. Chin Chung of ke Kulanui O Hawai'i (UH) School of Puhlie Health and Dr. Manuel Kau of the Department of Heahh. Our kamali'i Hawai'i had an average of 34 percent of their niho (teeth) decayed, missing, or filled, compared to 25 percent for all kamali'i examined. These figures may be contrasted with the 7 percent of decayed teeth found in skeletal remains of kamali'i in pre-haole Hawai'i kahiko (ancient Hawai'i). What factors account for puka-niho and what was like'ole (different) in Hawai'i kahiko that explain better dental health then than in modern Hawai'i? Experts tell us that for puka-niho to occur, there must be three linked essentials: 1. Particular mouth bacteria whieh act on kuha (saliva) to form "plaque," pasty material that sticks to ka 'ili-niho (tooth surface). 2. Sugar in the diet whieh is fermented by plaque bacteria to furm lactic acid. 3. Acid with sufficient manawa (time) to erode the enamei surface of ka niho to form puka-niho. In Hawai'i kahiko, according to Kawena Puku'i, our po'e kupuna (ancestors) removed dental plaques by rubbing woodash or charcoal with the finger on and between niho, and then rinsed their waha (mouths) with fresh salt water.

About the only sugar in the diet of pre-Cook Hawai'i was non-processed wai ko (sugar eane juice). But this was usually ingested by munching on the fibrous eane stalk, whieh also tended to remove dental plaque. Contrast those conditions of old with those of today, whieh we all ean correct pono'i (on our own). and thus prevent puka-niho, instead of paying expensive dentist's repair bills. The 1973 study showed that our kamali'i po'e Hawai'i ranked low in the frequency of toothbrushing compared to the other lahui. Our kamali'i need better home instruction and example in brushing off plaque at least twice daily — after breakfast and at bedtime. The brush must reach all the niho surfaces. ldeally, this should be followed by dental flossing to remove plaque that remains between adjacent niho. Excessive ko (sugar), especially in between-meal "snacks," were most frequent among our Hawaiian children in the 1973 report. Items such as candy, sugared gum. sugared soft drinks ("soda"), cookies, pies, eake and iee cream shou!d be avoided as daily fare and permitted only on special occasions. Acid erosion of ka niho will not occur if plaque is promptly removed and plaque harm is reduced if dietary ko is reduced. Since 1947, the incorporation of the mineral fluoride into the enamel of the developing child's tooth has been found to render the tooth more resistant to acid erosion. This ean decrease the occurrence rate of puka-niho by 50 percent. Fluoridation of niho enamel is best achieved by putting the proper amount of fiuoride in the drinking water supply, or by a daily dietary supplement of fluoride in liquid or tablet form for infants and children. With this as background, next month we will describe Ho'ola Niho — a proposal for dental health of Headstart kamali'i Hawai'i by the Health Issues Subcommittee of the State Association of Hawaiian Civic Clubs, chaired by Claire Hughes-Ho, nutritionist and past president of the Hawaiian Civic Club of Honolulu. Meanwhile, e mau ha'awi mai i mau ninau ola, ke 'olu'olu (please continue to send me your heakh questions).