ANCHORAGE, Alaska – Eight dental therapists who trained in New Zealand programs are cleaning, drilling, filling and extracting teeth in rural Alaska. But the American Dental Association doesn’t like it.
The therapists are not licensed in the state, and the training they received in New Zealand isn’t accepted as adequate by ADA standards. After a year of trying without success to prevent the therapists from treating rural residents, the ADA has gone to the Alaska Superior Court.
Not only does the organization want the eight practicing therapists ousted, it wants to make it impossible for four more who are currently studying in New Zealand to initiate practices in Alaska or any other state in America once they complete their coursework.
The Alaska Native Tribal Health Consortium maintains that with rates of dental decay at 2.5 times the national average and little hope of luring dentists or oral hygienists out to rural areas to treat residents, it has done the next best thing and hired the dental therapists. At issue is whether the therapists can fill cavities, extract teeth and clean teeth without causing “irreversible harm,” in the words of Sen. Tom Coburn, R-Okla., who initiated a measure to stop the activity in 2005.
The Senate Indian Affairs Committee rejected the Coburn measure; and according to University of Anchorage history professor Jeanne Eder, Lakota, there was good reason for that. “If people realized the tremendous distances and rugged terrain that [define] life in [rural] Alaska, they would be less inclined to point fingers.
“What are people supposed to do in the villages when they are a plane ride away from Anchorage? That’s several hundred miles and $500 round-trip,” Eder said. “My best picture of Alaska is to take an American atlas and to look at the state, superimposed on the U.S. What you’ll see is that Alaska is one-fifth the size of the lower forty-eight.
“So then for people to come in from a rural village like Kotzebue, up near the Arctic Circle, it would be like going from the middle of South Dakota to Alabama just to get to Anchorage – or even Fairbanks.”
Eder explained that Kotzebue is “extremely flat and desolate. It’s a tiny little berg with two restaurants or maybe three, a school, a small clinic, a technical center and some office buildings. What do you do when you live in a small place like that? And that’s the hub of that northwest area, where there are other smaller places surrounding it.”
“My question is, what dentist do you know that wants to go live there? Live in a place where the grocery store could fit in your house?
“What the ADA needs to do is train their own,” Eder said. “If they are so worried about it, why aren’t they training people to go out or creating some kind of flying dental hygienist��s aircraft that would go to the main hubs of the villages, just like a traveling medical van does?”
Clearly, the idea that Alaska gets short shrift from those in the continental United States has Eder more than concerned. “The problem is that people love to come up and see Natives sing and dance, but they’re not willing to help where the people really need help – and that’s in the villages. Alaska thrives on tourism – the Natives, the fishing and the scenery. It’s one of the most beautiful states around, like putting 10 Glacier National Parks in one – or even 20 or 30.”
Eder thinks the tribal health consortium is working wonders with scarce resources. “They are trying to promote healthy lifestyles and getting rid of [soda] pop in schools. They also have posters up that educate students and families about keeping teeth safe from sugar,” she said. “So I think the consortium has a right to hire dental therapists if all the ADA is going to do is complain and not come up and work with them.”