Dental Caries and Otitis Media Among Schoolchildren in Palau

Inger B. Appanaitis, William E. Lambert, Eli Schwarz, Michael R. Lasarev, Berry Moon Watson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Both oral disease and middle ear infections are highly prevalent in Pacific Island children. These diseases are multifactorial and likely attributable in part to both social and environmental factors. It has been two decades since these diseases were defined in Palau, and at the time were noted to be among the most common conditions and presented a substantial burden among Palau’s children. In 2006, the Ministry of Health in Palau began conducting comprehensive school health screenings in grades 1-11. While primarily used as a referral tool, this survey can also be used in epidemiologic studies to describe health trends. The current study utilized this screening data from the 2011-12 school year to characterize the prevalence of dental caries and otitis media and explore a previously suggested relationship between the two conditions, including common risk factors. It was found that over one-quarter (28.9%) of Palauan students had abnormal tympanometry results, with up to 17% indicating active otitis media. In addition, 85% of students had at least one decayed or filled tooth, with an average of 3.9 decayed or filled teeth in 12-year-olds. Both conditions were found to be more prevalent in public than in private schools; however, the two disorders were not significantly associated with each other. These findings place the prevalence of decayed, missing, and filled teeth, and otitis media in Palauan schoolchildren among the highest reported in the world. The widely recognized consequences of poor oral health and hearing impairment on learning, nutrition, and chronic disease make urgent the need for early intervention.

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalHawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health
Issue number6
StatePublished - Jun 2020


  • Children
  • Dental Caries
  • Epidemiology
  • Global Health
  • Health Disparities
  • Micronesia
  • Oral Health
  • Pacific Islander
  • Pediatric Audiology
  • School Health

ASJC Scopus subject areas

  • General Medicine


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