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Brushing in the Bush
Colgate Brings Dental Care To an Indian Tribe in Brazil
By MIRIAM JORDAN
Staff Reporter of THE WALL STREET JOURNAL


PIMENTEL BARBOSA, Brazil -- Possessing a strong physique and sporting wooden pegs through each earlobe, the elderly chief of the Xavante Indian tribe in Brazil strikes a commanding figure -- until he opens his mouth.

Several top teeth are missing. Many others are rotted beyond rescue. The chief, who goes by the single name of Serebura and is somewhere in his 80s -- he doesn't know his exact birth date -- didn't use a toothbrush and toothpaste until he was about 70 years old.

These days, Colgate-Palmolive Co. is trying to spare Serebura's 30-odd grandchildren and great-grandchildren (the polygamous chief can't keep track of his descendents) the same fate. The multinational company, working with Brazilian dentist Rui Arantes, is arming the onetime warrior tribe -- which still uses bows and arrows -- with weapons of modern oral hygiene.

For generations, dental care for the Xavante and other tribes consisted of twigs to scrape between the teeth and straw to wipe the tongue clean. That was all that was needed, given that their diet consisted of what they hunted or collected: tapirs, deer, fish, fruits and edible roots. The fare had a fortifying and cleansing effect on their teeth, dentists say. And though all the hard chewing eroded the Indians' choppers over time, cavities were rare.

Then came the "white man" -- offering gifts of tobacco, refined sugar and processed foods in exchange for mining privileges and other moneymaking activities. The Brazilian government inadvertently contributed to tooth decay by introducing rice -- the sticky starch causes cavities -- to Indians to encourage farming.

"We tried white man's food, and we liked it. Now we have toothaches," declares Chief Serebura, who says his problems stem from his acquired taste for sugar, cookies and coffee.

Between 1961 and 1991, the incidence of tooth decay quadrupled among six- to 12-year-old Xavante and rose more than fivefold among 13- to 19-year-olds. Overall, Brazil boasts developed-world standards of oral hygiene, with toothpaste consumption on a par with the U.S., at about 600 grams per capita annually -- 65% more than France, according to Colgate. But most Indians weren't using toothpaste as recently as five years ago. By the time Dr. Arantes studied the Xavante in 1997 as part of graduate work in public health, "immediate action was necessary to preserve the teeth of future generations," says the 38-year-old dentist.

So Dr. Arantes decided to take the Xavante's plight to a potentially powerful ally: Colgate. The company agreed in 1999 to sponsor a prevention, education and treatment program focused on five-to-14-year-olds.

In Brazil, Latin America's largest country and Colgate's fifth-biggest market, Indians account for just 280,000 in a total population of 175 million and generally don't have individual income. "I wouldn't call this a classic business-building process," says Roger Pratt, president of Colgate in Brazil. "We're not expecting to sell a lot of dental cream to Indians." Instead, Colgate considers the Xavante project, whose budget it won't disclose, as a socially responsible investment.

Next month, the project will extend to five other Xavante villages, with a total population of 10,000, as well to the Xingu National Park, home to about 4,000 Indians. Dr. Arantes will oversee two other dentists, and the goal is to slash tooth decay by 40% in five years.

For the past four years, Dr. Arantes has been visiting Pimentel Barbosa every four months for about 45 days at a time. To reach the village, he makes a backbreaking 24-hour journey from Sao Paulo by plane, bus and jeep. Each time, he lugs 500 Colgate toothpaste tubes and 500 toothbrushes (a pair for each villager), dental instruments, a 12-volt car battery to power a drill and a tent that he sleeps in.

Before starting his work, Dr. Arantes pays his respects to Chief Serebura and attends the Wara, a tribal council that convenes in the center of the horseshoe-shaped village each day for communal decisions. Through a translator, Dr. Arantes communicates his mission to the men assembled. Word quickly spreads that the dentist will be available for consultations.

The Xavante, who are recognizable by their square-cut shoulder-length hair with long bangs, were a nomadic tribe until about 30 years ago. Now settled, their living conditions have hardly changed: Extended families inhabit large palm-thatched huts. There is no running water, electricity or other modern conveniences.

Not a single Xavante woman in Pimentel Barbosa speaks Portuguese, and just a handful of Xavante men speak it. Especially in the early days, Dr. Arantes found little need to talk to his patients, once they opened their mouths. "They came in droves to get teeth pulled," he recalls. (He is now proficient in the Xavante dialect, Je.)

"Our priority is education and prevention," says Dr. Arantes, who teaches Portuguese-speaking tribesmen the ABCs of dental malaises -- plaque, gum disease and cavities -- which they pass on to the community. The dentist and the Indians also develop educational games, based on Xavante culture and customs.

One recent morning, after lunch at the Xavante schoolhouse, a tall Indian named Prepe gathered 15 students. Using a set of dentures and an oversize toothbrush to make his point, the Indian began: "Why are teeth important?" Several frisky children responded in unison that "we need them to chew, talk and have good health." Afterwards, Prepe handed every child a toothbrush with toothpaste, and four by four, they bent over a troughlike basin with four faucets and began brushing vigorously.

Dr. Arantes is confident that most youngsters here now brush their teeth regularly. One sign of improvement is that tribe members aren't just coming to see the dentist about toothaches. The other day, Monica, a Xavante carrying a newborn in a handwoven basket suspended by the handle across her forehead, asked for a checkup. Says Dr. Arantes: "The message about oral hygiene is getting across."

Write to Miriam Jordan at [email protected]

http://online.wsj.com/article/0,,SB105892228483859500,00.html?mod=todays%5Fus%5Fmarketplace%5Fhs

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CONTENT COPYRIGHT THE WALL STREET JOURNAL. THIS CONTENT IS INTENDED SOLELY FOR EDUCATIONAL PURPOSES.



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