Native Village
Youth and Education news

Volume 3, January 2012

The Shocking Facts Behind the Dental Crisis in Indian Country—and a Possible  Solution
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Condensed by Native Village

Tooth decay:
300 times more likely in American Indians than the general U.S. population. 
5 times greater in American Indian and Alaska Native preschoolers than the general U.S. preschoolers
Even more alarming is a statement made by Rep. Paul Goser (AZ) in the House of Representatives. Goser is a dentist:

"In many Native communities, between 25%-50% of preschool children have such extensive tooth decay that they require full mouth restoration under general anesthesia, compared to less than 1% for non-Native.”

LO RES FEA Photo Oral Health Maxine Janis DSCN0046 270x333 The Shocking Facts Behind the Dental Crisis in Indian Country—and a Possible SolutionMaxine Brings Him Back-Janis and Terry Batliner are of Native descent and oral health–care providers. Each is passionate about improving the lives of Native people through better dental care. They worked together on a oral-health survey team at the Center for Native Oral Health Research at the University of Colorado Denver.

Janis is Lakota and an an assistant professor at Northern Arizona University’s Department of Dental Hygiene. In July 2010, Janis returned home to the Pine Ridge Reservation and examined the teeth of her neighbors, friends and family.

“Sadly,” Janis says, “many children develop tooth decay at an early age, before the age of 2 years, when new teeth are particularly vulnerable and eating behaviors and speaking skills are just developing. As a result, children have to be hospitalized for treatment; if left untreated oral infection ensues and death could potentially occur. In addition, self-image and self-confidence are impacted.”

LO RES FEA Photo Oral Health Terry Batliner IMG 0049 270x202 The Shocking Facts Behind the Dental Crisis in Indian Country—and a Possible SolutionMost Americans can't comprehend the poverty levels on Pine Ridge. Toothbrushes, toothpaste and floss are unaffordable for thousands of children.

To make matters worse, many children lack access to professional dental care. Pine Ridge is the size of Connecticut, yet has only 3 Indian Health Service dental clinics. Those clinics have 2 shared hygienists to serve 40,000 residents. Drop in hours are limited.

Another problem: many residents can't afford the hours long drive to a clinic with limited drop-in hours.

For these reasons, Janis says, preventive services are unavailable to many, and root canals, crowns, dentures and bridges are rare.

This is why Batliner focuses on expanding dental care to the underserved.  Batliner has his MBA and a private practice in Colorado. He grew up in a middle-class home with a Cherokee mother and white father. Batliner consults with several foundations and is associate director with the Center for Native Oral Health Research.

“Our Native children have devastating dental problems in many  locations,” Batliner says. “We need dental therapists to treat the existing disease  and to institute preventive programs to reduce future oral disease.”

Both Batliner and Janis point to an innovative program that is serving young  people and adults.

“Alaska Natives are providing dental care to fellow villagers in remote communities," Janis said. "High school graduates who are willing  to return to their villages are recruited into a training program to become dental health aide therapists. In it, they are trained to provide basic care that will enable community members to preserve their teeth.”

Similar programs are being implemented in Minnesota and throughout the Pacific Northwest.

Batliner would like to see the Alaska program implemented throughout Indian country:

“A training program should be set up at a tribal college
“Local people from underserved areas should be recruited and sponsored  to attend the program by their tribe or Indian Health Service.
"The program would last 2 years with a 3-6-month preceptorship to follow.
"After graduation, the dental therapists should be contractually required to work in a dental shortage area for at least four years. Most will stay much longer if they are recruited from an underserved area.”

Batliner believes dental therapists “can provide basic dental care very effectively.” Basic care includes fillings, extractions, emergency care and preventive services. A supervising dentist would be consulted by telephone.

New technology and portable equipment can be taken to those in remote areas. With cameras, hand-held X-ray machines, Spectra and a laptop, health-care providers can determine which of those patients need the most dental care.

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