“Tribes are sovereign entities and there are cultural differences that have to be kept in mind whenever we do service provision, and it is best done by the tribe itself.”
—John Stephens, dental director of the Swinomish Indian Tribe
By exercising their rights to tribal self-determination, Native American communities have a crucial means of saving lives and protecting their members’ health. Legislators are aware of this. That’s why the House Community Development, Housing and Tribal Affairs Committee held a work session Feb. 25 on the oral health needs and the use of Dental Health Aide Therapists (dental therapists) in Indian Country.
Lack of dental care affects people’s ability to eat, work and go to school. When untreated, dental problems can lead to serious medical conditions like heart disease, diabetes, stroke and even death. A mother's poor oral health during pregnancy, for instance, increases her baby's likelihood of being low-birthweight, which can be a predictor of lifelong health issues.
For American Indian and Alaska Native (AI/AN) children, lack of access to routine and preventive dental care is having disastrous consequences. American Indian children ages 2-5 have the highest rates of tooth decay, nearly three times the U.S. average. More than two-thirds of American Indian children ages 2-5 have untreated cavities. And here in Washington state, AI/AN children get dental sealants at much lower rates than AI/AN kids in Alaska, where dental therapists practice.
Dental therapists are a successful, tribal-born solution that is based on a 90-year history of success around the world. Dental therapists are highly trained, culturally competent mid-level professionals that are recruited from, and serve in, the communities where they live.
During the work session John Stephens, Program Administrator for the Swinomish Indian Tribal Community, told legislators that 50 percent of the tribe’s dental patients could have been seen by a dental therapist instead of a dentist. Patients experience a logjam because “we are forcing [those who] don’t need specialized or complicated care to see a dentist.”
It is an “inefficient use of dentists’ time,” Stephens stated.
Sovereign tribal governments are in the best position to determine how to meet the needs of their community. The dental provider shortage in our state’s tribal communities has existed for more than 20 years, and it’s consistent with an overall shortage of dental professionals in 35 out of 39 counties in Washington. Dental therapists would provide a continuity of routine care for tribal communities and fill the need for a more robust network of culturally competent health professionals.
The Children’s Alliance works in partnership with tribal governments to exercise self-determination and provide the best possible oral health care for their communities. We are proud to continue working with the tribes and convening the Washington Dental Access Campaign to solve the oral health care crisis for all kids and families.