Cindy MacDougall
Northern News Services

Yellowknife (Nov 22/99) - Dr. Jim Tennant has pulled teeth out of the mouths of over 1,000 children in the past five years.

In the quiet of the operating room in Hay River, he does his best to save the teeth of children with severe tooth decay in the Deh Cho region .

"I've worked on children as young as 18 months," he says.

"For a child, it must be awfully traumatic to have something pulled from the mouth, to bleed from the mouth."

Many of the children whose teeth Tennant has pulled are pre-schoolers.

And he says it's never just one tooth that needs to go.

"It's usually multiples. Four or five teeth need to be extracted, and four or five need to be filled," he says. "All the teeth are in the same environment, in that one little mouth. If one is gone, many are gone."

Health professionals say massive tooth decay in young children is a severe problem across the Northwest Territories and Nunavut, one that some dentists are declaring has turned into a crisis.

In the Baffin area of Nunavut, 243 children are waiting for a chance to have cavity-ridden teeth pulled, filled or crowned in Baffin Regional Hospital's operating room.

Dr. Charles Pastori, who co-owns and runs the dental clinic in Iqaluit, says dental health has reached a crisis in Nunavut.

"I'm not sure I would call it an epidemic," he says. "But I'd call it a disaster."

Pastori says two major factors have caused this level of tooth decay in Northern children: parents who allow a baby or toddler to suck on a bottle full of sugary liquids, such as milk or juice, all day or night, and feeding a child a sugary diet.

The first may cause baby bottle tooth decay. A child's teeth may come through the gums already full of cavities.

This condition is commonly known as bottle-rot, and Tennant says the North has some of the worst rates of the disease in the world.

"There are multi-faceted reasons parents give a child the bottle," he says.

"If a child is particularly cranky, a parent may give them a bottle with something in it -- milk, juice, even sugar water -- to placate them. It may be that a grandmother has told (the parent) to do it."

Giving children sugary food and drink after they've left the bottle behind may cause cavities in healthy teeth.

"The real thing to do to limit this problem is eliminate or severely limit the sugar (children) intake," says Pastori.

Raouf Hammoud, dental program officer for the Baffin Regional Health Board, says he has no figures on the amount of children who have teeth pulled in the Baffin region each year, but he says the problem is serious.

Dentists come from the University of Manitoba and other institutions down south to help Nunavut's dentists keep up with the operations.

But the six- to eight-month wait for an O.R. appointment is caused not by a lack of dentists, but a lack of operating room nurses.

"If we had enough nurses to work the shifts, we could do an O.R. (dental surgery shift) every week," he says.

He says the next operating room session will start Nov. 29. About 30 children will be treated.

"I can see why some dentists are calling it a disaster," says Hammoud.

However, Dr. Gerry Uswak, the Baffin health board's dental consultant, says things have improved in Baffin in the past few years, even with the lack of nurses.

"Before, (another dentist) was just taking out teeth, and wasn't doing restorative work," Uswak says. "We put in silver crowns, and try to save as many teeth as we can."

Back in the NWT, there is no waiting list for dental surgery, according to Peter Hall, the Department of Health's dental program consultant.

"We have three facilities where we can do dental surgery," he says, "but we certainly do have a problem with oral health.

Hall says educating parents and communities about dental health is the best way to solve the problem, rather than simply blaming parents.

"A parent has to be interested in cleaning a child's teeth, because a small child can't do it themselves," he says.

Hall says a lack of dental therapists in the North also makes education and outreach in smaller communities difficult.

The NWT has seven dental therapists, who treat dental problems, give children fluoride, and educate the community about dental health. But there are five vacant positions in small communities.

"There seems to be very little interest in the North to study to become a dental therapist," he said.

Tennant says the message of dental health has to be carried by members of the aboriginal communities.

"Obviously, a white man telling them, 'You need to do this,' doesn't work," he says. "After all, I've been a dentist in the North for 26 years, and I'm still pulling teeth."