Fort Belknap Reservation Map
Map by Kristen Drumheller
Brushing Lesson at Fort Belknap

With some playful interaction, a boy on the Fort Belknap Reservation learns the importance of good oral hygiene.

Elizabeth Kinion

Project Leader Elizabeth Kinion, Ed.D, MSN, FAAN
MSU College of Nursing
Curriculum Vitae


Early Childhood Caries (ECC) is an acute and virulent form of dental decay that destroys the primary dentition of infants and toddlers, resulting in devastating impacts to child development and well-being and lasting consequences into adulthood. Children afflicted with ECC can suffer from poor nutrition, failure to thrive, poor self-esteem, pain, infection, and even death.

Using community-based participatory research, this groundbreaking partnership between Montana State University and researchers on the Fort Belknap Reservation examines the common problem of ECC among tribal and rural communities across Montana. Through cooperation with rural families, researchers hope to develop and implement an ECC-prevention program that can be community-centric, data-driven, and—most importantly—sustainable in rural settings of all kinds.

Centered upon the work of a trained and local community oral health specialist (COHS), the project’s intervention model will roll out in a series of carefully planned and agreed-upon steps involving guidance from community partners at every stage. The approach will consist of three strategic and innovative aims:

  • Aim 1: To build the research infrastructure and strategic partnerships needed to enable the Fort Belknap Reservation and the MSU College of Nursing to create and test a sustainable and effective community oral health specialist program to reduce the burden of Early Childhood Caries. An interprofessional ECC Research Team consists of a project director, a COHS, a population health dentist, a representative from the Fort Belknap Tribal Health Department, an Aaniiih Nakoda College faculty member, and student research assistants.
  • Aim 2: To develop and test in a two-part group design the effectiveness of a COHS–implemented ECC reduction protocol. All children who participate in the study receive dental disease prevention services from the project’s consulting dentist.
  • Aim 3: To assist and support Aaniiih Nakoda College in the development of a special training program that might produce ancillary oral health providers able to offer billable services to address oral health needs on the reservation.

Selected Project Accomplishments to Date

  • Hired a full complement of project staff, including Aaniiih Nakoda College students. Established relationships with the tribe’s community oral health specialist, the Fort Belknap Tribal Council, the Tribal Health Department, Aaniiih Nakoda College administrators, the Fort Belknap WIC (Women, Infants, and Children) clinic, and the Fort Belknap Head Start program.
  • Introduced Jane Gillette, DDS, of Bozeman, Mont., to the community and the Tribal Health Department. Dr. Gillette serves as the project’s consulting dentist.
  • Developed age-appropriate health education materials, created by Aaniiih Nakoda College students, including a children’s book about oral health written in the tribes’ native languages.
  • UP NEXT: Final recruitment of project participants (children ages 3-5 and their families) and initiation of data collection.

Related Publications and Presentations (Selected)

McKeon-Hanson, E., & Kinion, E. A tribal college and research university collaboration utilizing community based participatory research to address early childhood caries among American Indian children: A descriptive study, conceptual framework, and lessons learned. Manuscript submitted for publication.

Kinion, E. (2016). We can't do it alone: Building interprofessional relationships. Presentation at the 2016 Montana Public Health Association Annual Conference, Billings, MT.

Investigator Spotlight

Dr. Kinion’s early years were spent in the Seeley Lake area of Montana, where her grandparents and other family members had close friends in nearby tribal and rural communities. The older family members hunted and fished together in the Bob Marshall Wilderness. “One of the things I enjoy most is working in these beautiful parts of our state among communities with long and storied traditions,” she says.

Although her nursing background did not originally include oral health, Dr. Kinion’s research over the past decade and her expertise in interprofessional education have made her a respected authority among scholars and practitioners in the field. She has introduced an oral health curriculum to the MSU College of Nursing, where she co-teaches a seminar on the subject to nurse practitioner students. She also mentors graduate students who undertake projects related to oral health. “I learned that’s where I can help them the most,” she says, “and it’s something that’s desperately needed among nursing students who will work in rural areas.”

To Learn More

Read more about the project in this excerpt from the Spring 2016 CAIRHE Newsletter.