Oral health in transition: The case of Indigenous peoples from Brazil


  • Rui Arantes,

    Corresponding author
    1. Fundação Oswaldo Cruz, Unidade Cerrado Pantanal, Mato Grosso do Sul (Oswaldo Cruz Foundation, Cerrado Pantanal Unit)
    Search for more papers by this author
  • Ricardo Ventura Santos,

    1. Departamento de Endemias, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (Oswaldo Cruz Foundation. National School of Public Health, Department of Endemic Diseases)
    2. Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro (Rio de Janeiro Federal University, National Museum, Department of Anthropology)
    Search for more papers by this author
  • Paulo Frazão

    1. Departamento de Prática de Saúde Pública da Faculdade de Saúde Pública da Universidade de São Paulo (São Paulo University, School of Public Health, Department of Public Health Practice).
    Search for more papers by this author

Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. Email:arantesrui@hotmail.com or ruiarantes@fiocruz.br.


The objective of this paper is to summarise epidemiological information about the distribution of dental caries among Indigenous peoples in Brazil. The authors also present a case study of a specific group of Xavante Indians, one of the most numerous of Brazil's Indigenous peoples, describing how their oral health has deteriorated over recent decades, and showing how an oral health programme is attempting to reverse the present trend of increase in caries. The programme at Etenheritipá Xavante village incorporated three principal components: educational, preventive, and clinical. From the beginning, the programme included epidemiological record keeping for monitoring the level of caries in the population. Transversal studies of the condition of oral health among the Xavante of Etenheritipá were undertaken in 1999, 2004, and 2007. In the period from 2004 to 2007 the DMFS values in the 11–15 age cohort had a significant reduction in caries experience. The mean DMFS score fell from 4.95 in 2004 to 2.39 in 2007 (p<0.01). An increase in the percent of individuals who were free from caries was also noted: in 1999, 20% of adolescents 11–15 had no caries; in 2007, the proportion had risen to 47%. The Xavante case is a prime example of the transition in oral health that is taking place among the Indigenous peoples of the Americas, and it highlights the importance of oral health promotion through preventive measures such as access to fluoridation and basic care in reducing the inequality between Indians and non-Indians.