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Objective Adequate fluoride exposure is especially important for those experiencing disproportionately high prevalence of dental caries, such as rural Latino farmworkers and their children. Water is an important source of fluoride. This qualitative study examined water consumption beliefs and practices among Latino parents of young children in a rural community. Methods Focus groups and open-ended in-depth interviews explored parents’ beliefs about tapwater, beverage preferences and knowledge of fluoride. A questionnaire documented socio-demographic characteristics and water consumption practices. Qualitative analysis revealed how water-related beliefs, social and cultural context, and local environment shaped participants' water consumption. Results The vast majority of participants (N=46) avoided drinking unfiltered tap water based on perceptions that it had poor taste, smell and color, bolstered by a historically justified and collectively transmitted belief that the public water supply is unsafe. Water quality reports are not accessible to many community residents, all of whom use commercially bottled or filtered water for domestic consumption. Most participants had little knowledge of fluoride beyond a general sense it was beneficial. While most participants expressed willingness to drink fluoridated water, many emphatically stated that they would do so only if it tasted, looked, and smelled better and was demonstrated to be safe. Conclusions Perceptions about water quality and safety have important implications for adequate fluoride exposure. For vulnerable populations, technical reports of water safety have not only to be believed and trusted but matched or superceded by experience before meaningful change will occur in people’s water consumption habits.

Studies of the cultural/behavioral patterns that may be specific to ethnic subgroups with the highest risk for ECC seem essential to the development of effective prevention strategies.

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There is a high prevalence of oral disease in the Alaska Native population, much of which goes untreated, creating a large discrepancy between the level of their oral health and that of the general population. The causes of this discrepancy are multiple--a major cause being the lack of access to care, especially in remote Alaska Native villages. Improving the oral health status of Alaska Natives will require treatment of current disease and initiation of an effective program to prevent oral disease. Cooperation between the Alaska Native organizations, dental health aides, the dental profession, and the government will be important. A strategy that combines addressing the disease currently present and preventing the occurrence of disease in the long run is the only strategy that offers a sustainable solution.