Some Low German families seek medical interventions only when home remedies or their community’s lay practitioners are unable to resolve the issue.
In general, for those raised in colony environments, there is a lack of understanding with respect to dental care. Preventative dental care such as annual check-ups, regular scaling and daily tooth brushing has not been practised by many Low German people in Latin America. Fathers often remove loose teeth for children, and if children experience dental pain (especially if they still have their baby teeth), the tooth is usually extracted by a lay dental worker.
As with other medical concerns, accessing qualified dental practitioners is usually only done if/when lay dental workers have not been able to mend the situation. Many Low German families in Latin America do not have the financial ability to utilize qualified staff and/or the families live prohibitively far from appropriate dental clinics.
Oral hygiene practice and dental treatment in Ontario
Low German communities continue to have limited oral hygiene practices in Ontario. Dental care professionals who work with the Low German population consistently describe the obstacles these communities face in accessing appropriate dental treatment as complex challenges that include cultural differences, language and literacy barriers, (ongoing) migration between Mexico and Canada, poverty and immigration issues. Dental care practitioners are often limited in their ability to address these various barriers and to therefore see improved oral health in the communities.
“It is too far for me to go and drive to take all the children to the dentist.”
“We don’t have coverage, so we don’t go.”
Low German women generally state that all their children have toothbrushes and toothpaste. Some children reportedly brush at least once a day, and a few have access to regular cleanings. However, most parents in Ontario still only take their children to the dentist when the children are in pain and eligible for Children in Need of Treatment (CINOT). Some newcomer Low German families return to Latin America for Christmas, Easter or Pentecost holidays and will address dental needs such as dentures, crowns, and sometimes even root canals during those visits. Others will request that dental practitioners extract problematic teeth in Ontario if they are unable to afford the required dental procedures and/or cannot wait until the next visit to Latin America. This request is often surprising to dental practitioners if they are unaware of how prohibitive the financial costs of alternative dental care can be. Additionally, some Low German adults believe that the benefit of dentures (no more dental pain) makes them a preferable alternative to maintaining one’s own oral health.
Low German families in Ontario begin to access preventative dental care for their children when barriers to dental services are addressed (dentist provides this care for large families at a reduced cost, community-based dental clinics are easily accessed in rural areas, community workers liaison with families and dental services, Ontario Healthy Smiles programs are available, access to Children in Need of Treatment, etc.).
Nutrition and diet in relation to oral health
Low German people in Latin America and Canada experience significant differences in diet and eating habits. Many Low German people are not aware of how food habits affect oral health. Because oral health is not emphasized in their Latin American context, and because foods eaten there contain much less sugar, Low German people tend to be uncertain about why they seem to have more dental troubles in Canada even though they are engaging in more personal care (daily brushing) than they previously did in Latin America.
Foods in Latin America are often simple and unprocessed, with minimal sugar content, whereas in Canada there is a much greater variety of food available. This includes nutritious and healthy food but also pop, candy and chips. Packaged snacks arespecial treats in Latin America due to limited incomes. Typically, the only daily sugar intake would be jam for breakfast with candies and pop shared on special occasions. Like many immigrant groups, Low German people eat more highly processed and sweetened foods in Canada compared to their diets in Latin American. This is in part perpetuated by feeling pressure to buy packaged snacks for their children’s lunches to help them fit in. Low German mothers often describe wanting to provide their children with signs of affluence such as pop and sweetened milk. A practice that has become common in Ontario is to add strawberry or chocolate syrup (or other sweeteners) to milk. Some parents are coming to realize that packaged snacks and sweet drinks are not healthy habits.
Feeding babies
Many Low German women breastfeed but then use sweetened milk in bottles when the children are weaned. Bottle-fed babies will often be introduced to sweetened milk at four to six months of age. Mothers often seem convinced that children will not drink milk unless it is sweetened, even if they have heard that it is not healthy for their baby’s teeth.
