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Program Tackles Oral Health of Alaska Natives

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FORT LAUDERDALE—The numbers are staggering. More than 70 percent of American Indian/Alaska Native children ages 6 to 8 have untreated cavities. There are Alaska Native children who graduate high school with no teeth. Adults on the Colville and Blackfeet reservations have died from complications from tooth infections.

Attendees of the Native American Journalists Association (NAJA) annual convention heard these dismal statistics at a session on oral health in Indian country. Then they listened to proponents speak about a program that has brought dental care to 35,000 Alaska Natives.

Through this program, ten dental therapists trained in New Zealand (where the concept has been around for decades) for two years and now serve their native Alaskan communities. A dental therapist is not a dentist but more like a physician’s assistant or nurse practitioner. They are supervised by dentists, often remotely, by “teledentistry.” They are qualified to do preventative work, fillings and extractions, but not more complicated dentistry like crowns and root canals.

Alice Warner-Mehlhorn, program officer for the W.K. Kellogg Foundation in Battle Creek Michigan, called this dental training program “courageous and innovative.”

Warner-Mehlhorn told the conference attendees that the need for the program, which her foundation is supporting, was documented by the Alaska Natïve Tribal Health Consortium in 2006. “We need to make it easier for people to get appropriate dental care in their own communities,” she told the audience.

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The Consortium and the Indian Health Services Community Health Aide Program developed the program.

The concept is starting to take hold in the lower 48 states as well. According to Yvette Joseph, project manager for Spokane, Washington-based Kaufmann & Associates, the state of Minnesota in 2009 enacted a law authorizing the use of dental therapists. The Kellogg Foundation has started a $16 million project to pursue dental therapist programs in five states: New Mexico, Washington, Kansas, Ohio and Vermont. Other states are interested as well.

However, a potential roadblock is in the mix, she said: “Tribes must secure state legal authority to implement therapist provider programs.”

A study funded by Kellogg, the Rasmuson Foundation and the Bethel Community Services Foundation in Alaska found in 2010 “that dental therapists in Alaska are clearly providing safe dental services” and are “competent to perform the procedures within their scope of work.”

The Kellogg Foundation has put out a fact sheet saying “not enough dentists are serving AI/AN people. For example, IHS dental providers have a load of 2,800 patients per provider, while general population providers have approximately 1,500 patients per provider.” The Foundation also estimated that 26 percent of the dental positions at the IHS are vacant.

The Foundation noted that dental therapists earn salaries of between $50,000 and $68,000.