Alaska is 1/5 the size of the “lower 48”. It’s population according to the 2012 census was a little less than 750,000 with large portions of the population living in small communities spread out across areas the size of the state of Oregon. We have moved forward from the days of Balto and his sled team bringing medicine to the children of Nome; today, care is delivered from planes with air compressors and 500 pounds of gear to village health clinics. Care is provided not just for medical needs but also preventative dental care and treatment.
Dental therapist Conan Murat shares his narrative on providing dental care in the remote Yukon–Kuskokwim delta in the November issue of Health Affairs. I didn’t realize the distinction between dentist and dental therapist during my first read of the article as the care described appeared to be nothing less than excellent dental care. Mr. Murat brought the distinction to my attention.
Dental therapists, like me, known in Alaska as dental health aide therapists, are part of the dental care delivery system in more than fifty countries, including Great Britain and Canada…In 2005 the Alaska Native Tribal Consortium (ANTHC), which provides health services to more than 140,000 Alaska Natives and American Indians in Alaska and is the umbrella organization for more than thirty tribally owned health systems, brought dental therapists to Alaska.
Dental therapists are roughly the equivalent to physician assistants in the field of medicine. Under our scope of practice, we do evaluation, fluoride treatments, cavity excavations, fillings, and simple extractions- the routine work that takes up most of dentist’s day. We don’t necessarily work in a dental office, but, like dental hygienists and assistants, we are part of a dental team.
There has been pushback from the American Dental Association and Alaska Dental Society against dental therapists for allegedly practicing without a valid state license. However, the Alaska attorney general ruled in the favor of dental therapists and the ANTHC that they were within their rights to practice in tribal programs under federal authority. Minnesota is currently the only other state with practicing dental therapists and the University of Minnesota’s School of Dentistry has one of the only dental therapist programs in the country. The University of Washington School of Medicine also has a Dental Health Aide Therapist Program.
Importantly, Mr. Murat raised the fact that Alaskan Natives are not alone in their struggle for adequate dental care. He emphasized the fact that dental therapists should be a part of the solutions to America’s oral health crisis with millions of other Americans living in areas without enough practicing dentists to meet their needs or who can not afford a dentist or one who accepts Medicaid.
As someone who has had dozens of dental procedures, including maxillofacial surgery and a tooth implant, I will forever be indebted to the dental professionals who have treated my oral health needs for the past three decades. While much of the focus in the recent months has been on medical health care services, the health community should not, and can not, overlook the importance of providing quality oral care and prevention services in the United States, all 50 of them, as well.