For generations, Hawaiians recognized that true health depends on balance throughout the body. Our oral health is part of that balance. It is not just about appearance; it affects how we eat, speak, sleep, and even how our heart and blood sugar function.
When Europeans first arrived in Hawaiʻi, they described Native Hawaiians as having strong, healthy teeth – quite a contrast to many Europeans of that era whose sugar-rich diets and long sea voyages sustained by refined flour, alcohol, and salted meats often led to scurvy and poor oral health.
Archaeological studies of precontact remains support these accounts. Researchers found normal tooth wear and some periodontal disease in adults, but no evidence of scurvy or rickets – conditions that can signal problems with gum or bone health. Only about 10% of children had cavities, and just over 2% of their teeth were affected.
Today, oral disease is far more common. About 42% of Native Hawaiian adults have lost at least one permanent tooth due to decay or gum disease, and nearly 10% have substantial tooth loss. Among low-income preschoolers, 46% of Native Hawaiian children in Head Start have untreated tooth decay.
These differences are largely due to shifts in diet, alcohol, and tobacco use. Traditional diets were rich in whole foods that provided adequate amounts of vitamin C, calcium, and other nutrients important for oral health. They also included fibrous foods that required more chewing and increased saliva flow, helping wash away food particles and neutralize acids that erode tooth enamel.
In contrast, modern diets are high in processed and sugary foods that cling more easily to teeth and fuel bacterial growth that produces acid and erodes tooth enamel. Alcohol and tobacco further damage gum tissue and promote harmful bacteria.
Traditionally, Hawaiians used wood ash rubbed directly onto the teeth or mixed with salt water for daily dental care. Ripe noni fruit and puakala (native poppy) root were used to treat gum disease and infections. ʻŌlena (turmeric) and ginger may have been used to lower inflammation and promote healing. Post-contact, young guava leaves were chewed, or the inner gel of the aloe plant, were optionally applied for toothache and gum irritations.
Simple daily habits go a long way. Brush twice daily with a soft toothbrush. Floss your teeth daily. Rinse with water after meals. Limit sugary snacks and sweetened beverages. Drink water regularly to support saliva production. Avoid tobacco and alcohol. Managing blood sugar is especially important, since diabetes increases the risk of gum disease.
Keep in mind that oral health affects the rest of the body. Gum disease is a chronic inflammatory condition that can cause bacteria and inflammatory chemicals to enter the bloodstream. Left untreated, gum disease increases the risk of heart disease and complications from diabetes. In communities where chronic diseases are already common, protecting oral health becomes even more important.
By returning to traditional lifestyle patterns and maintaining daily hygiene habits, we can protect both our smiles and overall health.
