Experiences with the Streptococcus Mutans in Lakota Sioux (SMILeS) Study: Risk factors for Caries in American Indian Children 0-3 Years.

Severe Early Childhood Caries (S-ECC) is a terribly aggressive and devastating disease that is all too common in lower socio-economic children, but none more so that what is encountered in American Indian Tribes. Nationwide, approximately 27% of 2-5 year olds have decay while 62% percent of American Indian/Alaska Native children in the same age group have a history of decay (IHS 2010, NHANES 1999-2002). We have conducted a study of children from birth to 36 months of age on Pine Reservation to gain a better understanding of the variables that come into play in the development of this disease, from transmission and acquisition of Streptococcus mutans genotypes from mother to child to multiple dietary and behavioral components. This article describes how we established a direct partnership with the Tribe and the many opportunities and challenges we faced in performing this 5-year field study.