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

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