F.
Dental
Three
factors
resistance
of
incorporated
the
in
are
significant
tooth,
the
tooth
in
primarily related
surface,
2)
consumed, and 3) bacteria in the mouth.
flouride
intakes
and
initiating
generally
a
to
tooth
the
decay:
amount
the quantity and
of
1)
the
flouride
type of
sugar
Marshallese children have very low
high
sucrose
significantly increased incidence of tooth decay.
intake
producing
a
In addition, the typical
attitude toward a cavity is not to seek help until the pain has become
unbearable.
Though these factors operate throughout the Marshalls, the high
sugar consumption is greater in the urban centers of Majuro and Ebeye.
The DMF-S ratio (a standard measure of dental disease) was calculated
as 6.16 among school children on Majuro during 1966-68.
to 3.68 by 1977.
This had improved
The exact reason for this improvement, which reflects
Majuro children only, is not known.
To date no coordinated evaluation of
dental health on the outer islands has been done.
Previous attempts at
dental public health, through education, flouride mouth workers, and early
detection and treatment, have been severely hampered by lack of manpower and
finances.
G.
Nutritional
The diet of the Marshallese people living in the outer atolls consists
mainly of coconut, fish, breadfruit, pandanus and rice.
taro and arrowroot make up a smaller part of the diet.
Bananas, papayas,
The percentage of the
diet made up of each food type will vary depending on location and season.
Naidu et.
al.
(1980) reported that coconuts constitute up to 58% of the
diet and fish constitute up to 36%.
Vegetables are being added to the diet
by some people who are exposed to them and like them.
School children who
get two meals, breakfast and lunch, plus a snack, are being introduced to
some of these in order to meet U.S.D.A. recommendations for a balanced meal
and this introduction is leading to an acquired taste for more vegetables.
The diet of the people living in the population centers of Majuro and
Ebeye is largely imported and consists of purchased rice, canned foods, and
flour and sugar, since they have a cash economy and access to a greater
variety.
People now living on Enewetak Atoll are also eating imported food
given to them by U.S.D.A.
There are two reasons for this program.
First,
the islands that are inhabited were nearly completely denuded of vegetation
during
military
operations.
After
15
the
resultant
clean-up
and_
the