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Oral Health for All of Indian Country

Kevin Earle on oral health issues in Indian country
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Recent postings at Indian Country Today Media Network have highlighted roadblocks that stand in the way of many Native Americans receiving quality oral health care. It is apparent that there is a need for better education about oral health, tribal outreach and the coordination and facilitation of care in many communities.

However, these articles focused on a single proposal that has not been widely implemented or tested across tribal communities. We have learned that challenges and needs differ from reservation to reservation. It’s important to focus available resources on creating custom solutions that address specific tribal community needs.

We need a systematic approach in order to address access issues effectively. This includes identifying the most underserved populations within each reservation, conducting research to understand specific barriers to care, defining goals and measures for success, and using these findings to identify potential new solutions and ways to enhance efficiency. This is best done in collaboration with several partners and stakeholders who are committed to the community, and who can work together and pool their expertise and resources to enhance community members’ oral health.

With this in mind, I’d like to highlight two recent developments that have provided funds and advanced the discourse regarding Native American oral health.

(1) On July 26, the House of Representatives voted to accept an amendment from Rep. Paul Gosar (R-Ariz.), a former dentist, which allocates a $4.3 million plus funding increase to advance the oral health of Native Americans. When the final bill passes, the money will be given to the Indian Health Service, with a directive to use the funds on oral health.

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As most of you are aware, these funds are sorely needed. Currently, in Native communities between 25-50 percent of preschool children suffer from extensive tooth decay, which requires full mouth restoration under general anesthesia, compared to less than 1 percent of non-Native children. The funds could help minimize these health disparities.

(2) Additionally, in April, the 2011 Arizona American Indian Oral Health Summit brought together representatives from tribes, urban Indian organizations, IHS and key state, public health and private sector stakeholders to share information, resources and strategies for improving access to dental services and the oral health of Native American communities in Arizona. The Summit focused on important knowledge and capacity building issues, and facilitated peer-to-peer mentorship and collaborative problem sharing. The participants continue to work together today to identify and push forward strategies to remove barriers and enhance oral health care in Arizona Indian communities.

The Summit discovered many possible solutions, including increasing funding for oral health initiatives, improving the use of IHS resources and adding new members to the dental team. These solutions are all Arizona-focused and came through analysis of Arizona-specific issues. If more summits like this are held throughout the United States, we will be able to identify barriers to care and develop the right solutions to address each community’s particular challenges.

Now is the time for collaboration. We must all work together with open minds and without set agendas in order to improve oral health care in Native communities using available resources most effectively.

Kevin Earle, MPH, is Executive Director of the Arizona Dental Association, a founding member of the Native American Oral Health Care Project. Earle served as Committee Co-Chair for the 2011 American Indian Oral Health Summit.