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UNITED STATES
DEPARTMENT OF THE INTERIOR 
Office of Indian Affairs 
Field Service

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Bureau of Indian Affairs 
Washington, D.C. 

Eklutna, Alaska 
June 14, 1934.

Attention: Health, Dental Supervisor. 

Dear Dr. Cady: 

This week I talked to Mr. Thomas from the Washington office and he tells me that you were inquiring of the dental situation in Alaska. I am sorry that I have not written you long ago to tell you something of conditions as I find them. I have spent almost a year traveling from one place to another doing all I can for the natives and trying to discover a possible cause and cure for their deplorable dental conditions. I have studied them in their isolated villages, in the towns and in the orphanages and I think I have a rather comprehensible view of the entire situation.

It is my personal opinion that the cause of most of their dental troubles can be placed in the lack of food having mechanical cleansing properties. The natives living in the isolated villages where the diet consists of course and tough dried meat and fish have relatively good teeth. Their diet is certainly not chemically correct for good dentition so their lack of tooth troubles must be due to the mechanical cleansing qualities of their coarse food together with the strenuous use afforded the jaws. The natives living in or near white settlements invariably have the poorest teeth. It is not at all uncommon to do a full mouth extraction on a sixteen year old yet these twon natives have a better chemically balanced diet than the isolated ones. Neither of them waste any time or effort with burhsing.

The children in the institutions have the best teeth. At the present time I am stopping at the Bureau Orphanage at Eklutna where there are a hundred and ten inmates ranging in age from five to twenty-five. In the entire orphanage there were only a hundred and four cavities requiring filling and ten extraction. That is an average of only one cavity to the child which is by far the least of any place I have been yet. Here the children are fed a reasonable diet and are required to brush their teeth twice a day.  

From my observations I have come to the conclusion that the good teeth are due primarily to the mechanical cleansing properties of the diet and the poor teeth are the result of a lack of that property. I am sorry that by far the greatest number of the natives show a lack of a proper diet. 

Let us suppose that I am correct in my belief that the lack of cleansing properties in the diet is the cause of most of the trouble. We cant change the natives inherent liking for white mans food as long as we have white men to sell that food and we cant expect the native to buy and use a tooth brush when he does not even wash his face. I refer here to the adult native and I fear that there is very little hope for him when his habits of life are already formed but there is hope for the youngsters. The only way to overcome this lack of coarseness in the diet is by the strenuous use of the tooth brush which the white race is only now beginning to learn. Fortunately the nurses and teachers are doing a great deal of good in the way of dental education and I have always made it my policy to give a little lecture in every school, drawing pictures to show how and why teeth decay and trying to instill in the native the desire to keep their teeth clean to prevent tooth ache. Dental pain, I am sure, causes the natives more discomfort than anything else and if I can show them that brushing prevents tooth ache they can understand that better than if I approach the situation from a health or esthetic standpoint for after all the native is not interested in health or appearance.

It is my opinion that the Alaskan native is in the same position that the negro was two generations ago in so far as his health is concerned. They will improve in time but it will take longer than the negro because they are not in such direct contact with the white man. I cannot say that I like the life up here because living conditions are terrible but I do feel sorry for the natives and it is much easier to keep busy than stay idle so I work as much each day as I can on the things I think best for the natives. I can't do all of the work and what I do is done a bit too hurriedly. 

As to my personal problems. I am one dentist to take care of forty thousand natives scattered over a territory as large as all of the Western States together, 

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