Published July 20, 2017
One-fifth of Indian Health Service Dental Positions Remain Vacant
COOS BAY, OREGON-The Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians (CTCLUSI) this week became the first in Oregon to join the dental therapy movement, hiring dental therapist and CTCLUSI member, Naomi Petrie to provide oral health services in the community.
CTCLUSI is turning to dental therapists to make dental services available to tribal members who have long done without timely dental care in their own communities. Similar to the way nurse practitioners and physician assistants work with doctors, dental therapists work with dentists—either on site or remotely—to reach more people. Dental therapists deliver a core set of preventive and restorative services, including fillings and simple extractions.
On average, Indian Country has less than half the dentist-to-population ratio of the national average, and about one-fifth of the dental positions within the Indian Health Service are vacant. A recent study in the journal Health Affairs estimated that 2,825 American Indian or Alaska Native (AI/AN) dentists would be needed to eliminate national shortages of minority dentists.
“I’ve known Naomi Petrie since her involvement in the National Indian Health Board’s Tribal Youth Health Advisory Fellowship. Naomi will be a fantastic addition to the CTCLUSI oral healthcare team, just like dental therapy will be a fantastic addition to tribes across the nation struggling with poor oral health,” said Stacy A. Bohlen, executive director of the National Indian Health Board. “Oral health is in a state of crisis in Indian Country, and innovative solutions like dental therapy work. They fill gaps in the provider shortages, reduce long wait times, and provide culturally competent care.”
CTCLUSI is the latest to join the dental therapy movement. Dental therapists began practicing in Alaska and Minnesota a decade ago. Alaska’s program has expanded care to more than 45,000 Alaska Natives in need of preventive and restorative care. Dental therapists have since been authorized to practice in Maine and Vermont, as well as in Washington in tribal communities. Twelve states are currently pursuing legislation to enable dental therapists and numerous tribes have passed resolutions in favor of adding these mid-level providers to dental teams.
Naomi Petrie, who began work at CTCLUSI’s dental clinic on July 17, is the first Oregon student to graduate from the Alaska Native Tribal Health Consortium’s dental therapy education program and return home to practice.
Oregon authorized dental therapists to practice in several tribal communities as part of their Dental Pilot Project Program, assessing innovative models to expand access to dental care across the state. CTCLUSI is 1 of 3 sites partnering with the Northwest Portland Area Indian Health Board to train and employ dental therapists under this pilot. The Coquille Indian Tribe and the Native American Rehabilitation Association currently have students in training in Alaska, and CTCLUSI has a second student in training.
Native communities have some of the poorest oral health outcomes of any population group in the United States. Federal data for Washington, Oregon and Idaho show that American Indian children suffer tooth decay at rates 3 times the national average.
The dental therapist model creates a career pathway for young people from underserved communities. Dental therapists tend to be recruited by their home communities and return to practice in those same areas after completing their education. As a result, the care they provide is not only high-quality but responsive to the needs of the community.
“The suffering from oral health issues in the AI/AN population is unacceptable,” said Joe Finkbonner, executive director of the Northwest Portland Area Indian Health Board. “This pilot aims to turn the tide on that disparity, create a sustainable solution to the oral health crisis facing our communities, and provide a roadmap for all of Oregon to follow and learn from our experiences.”
This summer, seven more students from Oregon, Washington and Idaho will join their Alaska peers and begin their 2-year dental therapy training with the Alaska Native Tribal Health Consortium’s dental therapy education program in Alaska. The program’s recent affiliation with Ilisagvik College in Barrow allows students the opportunity to earn a degree, and apply for scholarships and federal student aid.