Updated

Alaska Native children in remote villages have rates of tooth decay about four times the national average, a government study showed.

The study, which tracked dental health of children in the mostly Yupik Eskimo region of southwestern Alaska, pinned the blame on two major factors -- lack of fluoridated water and an abundance of sugary, carbonated soda pop.

The ravages are readily apparent in villages where many young children need major dental reconstruction work, said Dr. Brad Whistler, Alaska state oral health director and a co-author of the study.

"When they smile, you see a lot of silver teeth," he said.

Such severe decay sets up children to have serious dental problems as adults, Whistler said.

One reason for the high level of tooth decay is poor water-system infrastructure in many Alaska Native villages, which prevents the fluoridation of drinking water that has helped lower rates of tooth decay in other parts of the United States, Whistler said.

In some villages that were part of the study, residents must haul water home from central pumps, he said.

Even those places with more sophisticated systems are likely to lack fluoride in drinking water, because few qualified technicians are available to work in such far-flung locations and install the necessary equipment, he said.

The other major problem is the erosion of the traditional Native diet, as the introduction of food laden with sugar has left its mark, Whistler said.

The study, by the federal Centers for Disease Control and the Alaska Department of Health and Social Services, analyzed 2008 dental records and habits of 348 children between the ages of 4 and 15.